Case 28: Immediate implants and Immediate provisionalisation
Case 28: Immediate implants and Immediate provisionalisation
Sometimes, when periodontal support is fair and if we have poorly designed FPDs as in this case, where root stump in 2.1, Cantilevered 2.3 from 24, and cantilevered 1.3 from 1.4 and 1.5, requires careful planning for a full arch fixed restoration.
Although the patient was given a complete plan, he refused and wanted to correct the anterior esthetics alone. He had a low smile line making things favorable for the recession not to be seen when he smiles. History reveals, the patient had a fractured tooth in 2.1 where his local dentist provided a transitional treatment just to satisfy the esthetics, by bonding the broken crown with composite resin to the adjacent teeth.
Additionally 2.2 had root caries and thus was planned for extraction. Considering 2.3 as a cantilevered pontic, after CBCT analysis we could plan two implants in the sites of 2.1 and 2.3
The implant has excellent primary stability, and we planned for an immediate anterior cement retained provisional. Luxatemp was the material of choice in this case. An initial diagnostic mock up was done and a putty index was made. After the angulated abutments were torqued and the screw access was filled with composite, a luxatemp provisional was fabricated with the putty index chair side.
We can see from the smile line that the cervical third was not at all visible and it was not that tough to mange smile curve and the incisal exposure. After a period of 6 months definitive prosthesis needs to be done.
Sometimes, when periodontal support is fair and if we have poorly designed FPDs as in this case, where root stump in 2.1, Cantilevered 2.3 from 24, and cantilevered 1.3 from 1.4 and 1.5, requires careful planning for a full arch fixed restoration.
Although the patient was given a complete plan, he refused and wanted to correct the anterior esthetics alone. He had a low smile line making things favorable for the recession not to be seen when he smiles. History reveals, the patient had a fractured tooth in 2.1 where his local dentist provided a transitional treatment just to satisfy the esthetics, by bonding the broken crown with composite resin to the adjacent teeth.
Additionally 2.2 had root caries and thus was planned for extraction. Considering 2.3 as a cantilevered pontic, after CBCT analysis we could plan two implants in the sites of 2.1 and 2.3
The implant has excellent primary stability, and we planned for an immediate anterior cement retained provisional. Luxatemp was the material of choice in this case. An initial diagnostic mock up was done and a putty index was made. After the angulated abutments were torqued and the screw access was filled with composite, a luxatemp provisional was fabricated with the putty index chair side.
We can see from the smile line that the cervical third was not at all visible and it was not that tough to mange smile curve and the incisal exposure. After a period of 6 months definitive prosthesis needs to be done.
This case was done by me at Parasu Dental Hospital, Chennai.
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