My patient who alternates between our office and the periodontist office came in today. She had been told a few months ago by the periodontist that her upper canine tooth crown was failing and would come out soon. But as most patients and people are we hate to go see our dentist until…..it breaks
Broken upper canine tooth. She had super glued the post and Porcelain fused to Metal crown to the root for the weekend. Not a great solution as you can see from the gum tissue. But I thought it was quite creative.
X-ray of the broken tooth with the crown and post missing.
To get the rest of the root out without damaging the delicate plate of bone on the cheek side I had ordered some SalvinPDL-elevators. These are thin bladed instruments used by the dentist to remove the broken root without damaging the bone. Thanks Chris Totty for sending them out. I had another brand but needed another set and I quite like these. Plus Salvin Implant Supply is here in Charlotte NC.
Canine root being removed and as much bone being preserved as possible for an OCO Biomedical ISI 4.0mm dental implant placement. With this kind of implant we can predictably load the implant without a surgical flap and have a 99.9% documented success rate. Patients no longer have to suffer with the healing of a invasive gum flap and a time intensive two state surgery.
Now with the canine root out I could check the quality of bone and pick what dental implant would make the most sense to place. We could let the area heal and place a few mini dental implants or consider a one piece OCO Biomedical Immediate Stabilized Implant.
Having a stock of OCO Biomedical Implants that Matt Baron and Chris Sanchez had sent me I quickly found a OCO ISI 4.0 x 14mm that would work great in a situation like this.
Following the simple OCO dental implant placement protocol I used the pilot bit to ensure the correct angle was being followed and took an xray to confirm.
OCO Biomedical ISI 4.0 x 14mm dental implant in the extraction site. Notice the gold color Titanium Nitride finish. This will give a good warm color to the implant and final crown under the gum tissue.
Final x-ray showing the OCO Biomedical ISI dental implant in place spaced correctly between the two adjacent teeth and capturing 3mm of bone past the end of the extracted root for immediate stability. I used her existing PFM crown as her temporary by grinding out the old post from the inside of the crown and cementing it over the OCO dental implant with temporary cement.
I used her old PFM crown as a temporary and fit it right over the OCO ISI dental implant.
Final Pan x-ray with the OCO ISI dental implant and PFM temporary crown in place. The patient will come back in 6 weeks for a tissue and healing check. If all looks good an impression will be taken for First Impressions Dental Lab to make the all porcelain crown to fit over the dental implant. I will post the final crown picture at that time.
I think this case could have been solved either with a mini dental implant capturing the palatal slope of bone or a traditional implant as shown. I have done both and they both will work well with the proper training. I am encouraged by the number of dentists who are now seeking to get dental implant education. There are several great mini dental implant seminars and education as well as regular implant CE courses. I encourage any dentist to get started and mini dental implants are a great way to move forward in helping our patients.
Paresh B Patel Dentist Mooresville NC