Topic

[Surgery]  46 immediate implant 1 wk post op..need for concern?


Hi doctors

 

Attached photos are:

Image 1: PA at initial implant surgery

Image 2: Intraoral photo at initial surgery

Image 3: PA 1 wk post op

Image 4: Intraoral photo 1 wk post op

Image 5: Original PA of 46 showing VRF of MB root.

 

Here is the history of this case: 

I performed a 46 extraction due to a lingual vertical root fracture of the MB root. The roots fractured during the extraction below the furcation and to preserve bone, I decided to drill the roots out and cleaned out the granulation tissue. Then I placed an immediate implant (5x11.5mm Hiossen ET3) 1.5mm below the buccal bone crest and grafted the socket with allograft mixed with PRF membrane and clindamycin injectable solution followed by a 7mmx5mm healing abutment with PRF membrane over socket.

 

I just saw the patient for 1 week post op and I have some questions that I hope you can answer:

 

1) on closer inspection, I may have left a thin layer of tooth on the mesial as I can make out a PDL near the healing abutment. Could this pose a problem?

2) at 1 wk post op, the tissue has healed very nicely everywhere except the distal where there is now a hole that I believe leads down to the implant. The allograft particles has been lost in that area and the PRF membrane is already resorbed. Is there any need for concern right now? Will this affect the bone level?

 

Thank you for you input.


by Mike Zhou at Fri, Oct 30, 2015 12:53 AM

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Bernard Jin Replied at Fri, Nov 6, 2015 4:14 AM

Hi M******* As we spoke in the last study club - I believe the PRF was extremely thin or lacking at the defective site. Having said that - keep us posted on the progress. Would be interested in seeing it a few weeks from now. Do take photos!



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Ho-Young Chung Replied at Sun, Nov 1, 2015 3:11 AM

Hi there, I think this was a very well executed case. The PDL that your seeing on your PA appears to me that you may not have curretted that part of the socket as thoroughly. I don't see any root fragments on the PA. The distal will likely heal just fine. The 1 week post-op PA shows radiopacity on the distal. The healing abutment that you chose is also ideal. Implant angulation is great and you should get a nice emergence profile for your final SCRC. Ho-Young