Maxillary central incisor: Immediate implant placement and periodontal plastic surgery
A 37-year-old female patient presented with a 5.0 mm periodontal pocket on the facial surface of the right central incisor with moderate periodontal inflammation. After a CBCT scan was performed, external root resorption was discovered on the facial surface which required tooth extraction. It was observed during the clinical examination that 3.0 mm of gingival recession was present on the facial aspect of the left central incisor.
The objective of the treatment was to replace #11 FDI (#8 US) using immediate implant placement and to perform root coverage of the #21 FDI (#9 US) using a connective tissue graft.
A NobelActive regular platform (RP) 3.5/13 implant was placed, with a temporary abutment. Geistlich Bio-Oss was placed in the gap between the implant and bone. The definitive restoration was fabricated using a Universal Base and 1.5 mm abutment height, a zirconia individualized abutment, and a lithium disilicate (IPS e.max) ceramic crown.
Evaluation & Diagnosis
Treatment Planning
Progress & Completion
Follow-Up & Outcome
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extraction can be avoided
extraction cannot be justified.
i feel tooth can be saved.
lot of options available for saving teeth

Was an Endo opinion taken before extracting the tooth?? To avoid medico legal scenario.....

The shape of the crown during cementation and at the 1-year recall appear to be different.
Fantastic results. Absolutely loved it. One question I had was - the shape of the crown after cementation and the shape at the 1-year recall appear to be different; the crown is more squarish in the cementation photo. Were any changes made? Also, in retrospect, is there anything you would do differently if you had to do the same case all over again? Thanks in advance.

Justification of the the Extraction
Comments:
1. The Implant Platform diameter discrepancy corresponding to the 11 root diameter at ECJ!
2. Lack of LCPPA radiograph before and after and follow-up!
3, Simultaneous correction of the recession of the adjacent tooth 21!
4. Extreme vicinity Prov. rest. margin to the Implant-abutment interface or Bone margin violating the Biological width!
5. Lack of GBR technique in the presence of Straumann bone Ceramic (membrane?)!
6. ..............
In reply to Justification of the the Extraction by Nico kamosi