CLINICAL FINDINGS
  • Endodontically failing maxillary left central incisor
  • External root resorption
  • Need for preservation of natural gingival emergence profile
  • Existing esthetic soft tissue contours requiring maintenance
  • Tooth planned for immediate implant replacement
  • Pretreatment digital periapical radiograph demonstrated external resorption of the left maxillary central incisor.
  • Implant planned in palatal aspect of extraction socket with depth determined by contralateral central incisor bone contour.
PP
Dr. Paul Petrungaro
Moderator · IML CaseRounds™
  • Importance of preserving soft tissue emergence profiles in the esthetic zoneBenefits of immediate implant placement and provisionalization:
    • Reduced treatment time
    • Fewer surgical procedures
    • Improved patient comfort
    • Preservation of papillary tissues and gingival contours
    Role of minimally invasive/flapless surgical approachesImportance of atraumatic extractionUse of surgical guide/provisional systems (TempStent II)Simultaneous bone grafting and tissue preservation techniquesImmediate provisional restoration as a tool to sculpt gingival tissues
Surgical

TOPIC B- IMMEDIATE RESTORATION OF DENTAL IMPLANTS

Failing maxillary left central incisor requiring extraction and implant replacement while maintaining esthetic soft tissue contours and emergence profile.
PATIENT SUMMARY
AGE / SEX
33
CHIEF COMPLAINT
Failing maxillary left central incisor requiring extraction and implant replacement while maintaining esthetic soft tissue contours and emergence profile.
ASA CLASS
Class I
SMOKING
Non-smoker
KEY MEDICATIONS
Augmentin (GlaxoSmithKline) prescribed prophylactically: 1 tablet every 12 hours starting the day before surgery 1 tablet one hour before the procedure
WORKING DIAGNOSIS
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    • DR. PAUL'S TREATMENT PLAN
    1. Diagnostic wax-up and fabrication of TempStent II surgical guide/provisional system
    2. Preoperative antibiotic therapy with Augmentin
    3. Atraumatic extraction of maxillary left central incisor
    4. Socket debridement and removal of granulation tissue/periodontal ligament remnants
    5. Immediate implant placement (3.7 × 13 mm Zimmer implant)
    6. Implant positioned palatally with depth guided by contralateral tooth bone contour
    7. Healing screw placement
    8. Bone grafting with mineralized cancellous graft
    9. Immediate provisional restoration to maintain emergence profile and esthetics