Management of an iatrogenic case following traumatic tooth extraction, bone graft and implant failure
A 30-year-old female patient who lost tooth #13 FDI (#6 US). She reported the traumatic extraction of the canine, which resulted in a significant vertical bone loss of 3 mm and an advanced horizontal lingual defect. After the extraction, a bone graft and an implant insertion were attempted: both graft and implant failed.
The lateral incisor exhibited a broader periodontal ligament (PDL), mobility class II and periodontal attachment loss up to 9 mm. The surgical solution was the removal of the remnants of the failed bone graft, guided bone regeneration (GBR), implant insertion, and mucogingival plastic surgery to boost the biotype. A lithium disilicate (IPS e.max®) single crown restoration was used in this case.
Evaluation & Diagnosis
Treatment Planning
Progress & Completion
Follow-Up & Outcome
Questions
Ask a questionWhat were the occlusal contacts on tooth 13 after the crown installation?
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.

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

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?


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

I would like to know what causes a "creeping attachment" and will the gingiva eventually remodel?
What bone graft material did you use and what did you use to hold the graft?
In reply to What bone graft material did you use and what did you use to hold the graft? by Leslie Tu
In reply to What bone graft material did you use and what did you use to hold the graft? by Leslie Tu