This video is part 1 of a 2-part series which details the treatment of a hopeless maxillary anterior tooth. Part one discusses post-extraction socket healing and site development for implant placement. Part two will discuss the steps of implant placement, provisionalization, and final restoration.
The case involved tooth 7, which had a lesion and a history of root canal therapy. The plan was to extract the tooth, and let it heal. Analysis of the extraction site 2 months after extraction revealed buccal resorption. The video explains in detail why buccal plate resorption occurs following extraction and how the defect was successfully managed in this particular case. We hope the video provides some important lessons for guided bone regeneration in these types of situations via comparison of the pre-op and post-op photos.
In Part II of the series, we describe the implant placement, provisionalization and final restoration. Despite successful regeneration of the original defect, the contour was obviously deficient and was addressed by employing the “Sandwich Technique”. This entailed the use of an autogenous bone layer (see Autogenous Bone Collector or followed by Xenograft Particulate that is layered over the autogenous bone. Following integration, a provisional was fabricated to shape and contour the peri-implant tissue and a final restoration was fabricated. One interesting topic that is brought up during the restoration phase is the issue of residual xenograft material in peri-implant soft tissue. How to handle the residual graft is still somewhat debatable with some clinicians claiming it should be cleaned out with other suggesting it’s good for stability of the soft tissue.
