Single Implant Study
46 year old lady wanted advice and possible treatment on a failing ur1. She was very reluctant about attending as she had been told by several dentists that her only option was a denture, something she never wanted. The tooth was exposed completely to the apex of the root. She requested that at no point could she tolerate a denture.
Clinically and radiographically it is obvious ur1 had no bone support. There was no option but to remove the tooth. As she had requested to avoid a denture so therefore a simple rochette bridge was constructed and planned to be placed the day the tooth was removed. We were also aware that some bone grafting would be needed, however as the gum was in such poor condition, a full thickness graft is also required to increase the quality and quantity of keratinised tissue in the area.
Tooth was removed and as seen, large gingival defect present. A full thickness free gingival graft was taken from the roof of her mouth to increase the amount of kerantised tissue
2 months were left for healing. As seen soft tissue healing was excellent but a large bony defect was notes. A Biomet 3i implant was placed although with simultaneous Guided Bone Regeneration. A coverscrew was placed and the implant is completely covered for 3 months.
Healing was uncomplicated and at 3 months the coverscrew was replaced with an ENCODE healing abutment. Healing was complete in 2 weeks and final implant impressions were taken. Biomet 3i ENCODE abutments have unique codes embedded on the occlusal surface that eliminates implant level impressions. A simple putty and wash impression is taken of the ENCODE abutment in place.
3rd and final stage involves removing the ENCODE abutment and restoring the implant with a customised titanium abutment bonded crown.
Radiographs and summary
2nd stage, ENCODE abutment
Even though at initial presentation this appeared to be a very challenging case, I was confident an excellent result could be obtained. The treatment was completed in 6 months and the initial concern of having to wear a denture was never needed.