This patient's front tooth had an existing crown that was hanging down because the root was fractured. It was not restorable. The panoramic and individual radiographs confirmed the fracture. The intent was to extract the tooth, place an immediate implant if possible, and if the stability of the implant was sufficient then immediately place a tooth on the implant.
We removed the crown, and then extracted the root with periotomes in order to not injure the boney socket. After confirming the socket was intact, it was curetted, and sequential drills were used to extend and shape the site according to the anatomy as seen on the CAT Scan. The appropriate sized implant was then chosen and placed. The Implant Stability Quotient (ISQ) was measured with the Osstell Resonance Frequency Device and it was determined that the implant was stable enough to have a tooth placed on it immediately. An abutment was screwed onto the implant and the patient's own crown was relined to fit the abutment and placed with temporary cement.
After osseointegration of the implant is complete, a custom abutment will be placed and a new permanent crown fabricated.
Robert G. Tupac, DDS, FACP, Inc., Diplomate, American Board of Prosthodontics (661) 325-1275 | www.drtupac.com 5060 California Ave., #170, Bakersfield, CA 93309