Patient presented in our clinic for extraction of tooth # 36 and dental implant replacement after it was diagnosed non-restorable by the patient's dentist.
Treatment plan:
- Extraction of #36 and socket graft
- Dental implant placement 3-4 months later
- Restoration of the dental implant 2-3 months later.
Upon extraction and thorough disinfection of the socket, a facial dehiscence ranging from 8-11mm was identified. Also, a 4mm deep 4-wall defect was found on mesial of tooth #37.
The #36 socket and the periodontal defect on #37 were grafted with a mixture of FDBA and tetracycline and covered with a cytoplast membrane. The membrane was left exposed. Oral hygiene instructions to the patient involved chlorhexidine gel 0.2% application 3 times per day for 7 weeks until the membrane was removed.
A Legacy3 5.2x10mm dental implant was then placed 4 months later presenting high initial stability. After 1 year post-op, good bone stability around the implant can be observed. Also, the defect on medial of #37 responded favorably as it can be observed clinically and radiographically.
The technique used in this particular case could be utilized in posterior sites with a thick soft tissue and where large amount of bone augmentation is required. Patients medical history should be clear so proper healing could be expected. It is not recommended for patients with potentially impaired healing like diabetics and smokers.
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