Sinus lift, intra-operative minor complication (treatment and follow up)

Treatment Plan:
-Extraction of #15 and dental implant placement on #15 and #16.
-Fabrication of a new PFM crown on #17.

Sequence of treatment:
-Temporary FPD #15-17
-Sinus graft with lateral window on site #16

    6 months later
-Extraction of #15 and immediate implant placement
-Implant placement on #16

   2-3 months later
-Fabrication of PFM crown #17,
-Fabrication of implant crowns for #15 and #16

Critical points on treatment:

Why not to remove #15 at the time of the sinus graft surgery?
In order to minimize the amount of time that the patient will be without teeth on that side (from 9 to 3 months).

#16 implant size choice: 4.2mm diameter
Why?
The crown size of this molar is small compared to an average first molar size. It is actually similar in size to a premolar tooth. However, the forces that this tooth will receive are equal to a molar size tooth.

Do you have any question about this case?. Feel free to comment.

Best,
Ioannis

Canines Exposure by Dr.Vergoullis

In this video we present the exposure technique of buccally positioned impacted canines.

When performing this type of surgery, it is very important to maintain a zone of attached keratinized gingiva on the facial aspect of the teeth.

If the surgical technique includes the removal of the flap, including the keratinized gingiva that might be covering the impacted tooth, then when the tooth is repositioned by the orthodontist to its final position you might end up with only mucosa on the facial aspect of it.

The presence of only movable mucosal tissue around teeth can lead to gingival recession. This is especially true for the canines. The root prominence of these teeth might lead to the formation of bony dehiscence upon facial movement of the root during the orthodontic treatment. When dehiscence is present in absence of keratinized gingival tissue, then the development of gingival recession is possible.

Ioannis