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Initial clinical situation. The pre-operative buccal view is showing a missing canine associated with mucogingival deformities as the results of a traumatic extraction of the retained canine. A bone graft was attempted as well as an implant insertion: both bone graft and implant failed.
Three years post-op: the line has disappeared due to the natural collagen turnover.
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Patient cases:
Single-unit restorations
(Maxilla / Posterior)

Management of an iatrogenic case following traumatic tooth extraction, bone graft and implant failure

Lead:  
Giorgio Tabanella

Questions

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asked by Leslie Tu

What bone graft material did you use and what did you use to hold the graft?

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asked by Petronela Petrosel

What were the occlusal contacts on tooth 13 after the crown installation?

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Hello dr. Great job, here. I’d like to know more about the occlusion on that tooth, #13. After you installed the final crown and after 4 years follow-up. Thank you.
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asked by Stephen Zeller

You mentioned you did mucogingival plastic surgery to boost the gingival biotype. What did you do and when?

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You mentioned you did mucogingival plastic surgery to boost the gingival biotype. What did you do and when? I am also curious how you resolved the 9 mm of attachment loss you had on the mesial of the lateral incisor. Some would have removed #7, included that site with the GBR and constructed a two unit bridge with #7 being a cantilever. Did you consider that in your treatment plan?
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Dear Stephen, the mucogingival plastic surgery to boost the peri-implant mucosa was performed at the time of uncovery.  The technique I utilized is called "The Buccal Pedicle Flap". It will be published on the International Journal of Esthetic Dentistry Volume 14 Number 1 Spring 2019. The technique is minimally invasive, it does not require any CT graft, it can be applied for anterior and posterior as well as single or multiple implant sites. The technique can increase the mucosa thickness as well as the band of keratinized tissue. Please don't hesitate to let me know if you need further info. Regards, Giorgio Tabanella 
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asked by Stephen Zeller

How did you resolve the 9 mm of attachment loss on the mesial of #7? Did you consider removing it and doing a cantilever bridge?

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Tooth #7 had a poor/guarded prognosis due to attachment loss so an extraction was planned at the beginning as well as implant placement in area #7. However by extending the recipient site not only at the level of the edentulous area but also palatal to #7 it was possible to obtain a repair: no periodontal pockets were reported after GBR. After a follow up of almost 6 years from the delivery of the final restoration the periodontium on #7 is still stable. My Best Regards, Giorgio Tabanella
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asked by Irina Trajkovska Zareska

Why did you used litium disilicate crown and not a zirconium one?

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asked by Gladson Costa

Why did you use uncomon form for this crown? Why did you change the top of this tooth?

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asked by Victor Paredes

¿Realizo controles radiográficos durante los seguimientos?

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Team members

Periodontist