[Surgery]  11 immediate implant infected site

This patient presented with a long standing draining fistula in the 11 site. External resorption has taken place. There is a history of trauma many years ago. I am proficient with PRF sticky bone but not the catheter technique. I can attempt 2 draw technique. I assume I am aiming for a 4 or 4.5mm implant 2-3 mm apical to the socket for primary stability. Can someone walk me through how they would tackle this case. Would you place immediate crown.





by Chad Denomme at Fri, Dec 16, 2016 1:13 AM

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Mark Kwon Replied at Fri, Dec 16, 2016 7:01 PM

Dear chad, Seems like no buccal plate. Do not place wide implants it will be difficult to tegrow buccal bobe on wide implants at anteriors. 3.5mm is still the ideal diameter. Few determined ning factors: provided that pt us healthy 1. Pt expectation 2. Smile line 3. Interproximal tissue height 4. Buccal tissue cobdition 5. Oj/ob 6. Parafunctions 7. Bone density 8. Bone volume Some preop photos will be helpful! thanks!

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Ho-Young Chung Replied at Fri, Dec 16, 2016 4:49 PM

Hi Chad, This has unpredictability and challenge written all over it. I can't determine how much of the buccal plate remains based on 3 cross sectional slices but I'll bet that sliver you see on one of your slices isn't much (and will either come out with tooth or resorb very quickly). For treatment planning any anterior case (as well as posterior), you must have wax-up, intra-oral photos (complete), a wide arrange of radiographs including a PA and a Pano, and CBCT w/ measurements. The cross sectional slices that are posted need at the bare minimum measurements and it also needs to go more lingually and apically (it has been cut off). I personally would advise anyone to think twice about tackling this case unless that person has at least 20-30 (successful) immediate anterior implants under their belt. Cheers, Ho-Young

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Chad Denomme Replied at Fri, Dec 16, 2016 1:28 AM