Immediate Implant Placement at #45 Following Extraction of Cracked Tooth
Surgical Procedure
Chief Complaint
Px c/o pain and discomfort at #45 during biting and function.
Clinical Findings
#45
TTP, TTPp positive
Mobility WNL
Probing depth WNL
Bite Test positive
Transillumination test positive
Deep mesio-distal crack noted with light refraction extending below gingival level
Treatment Plan
Diagnosis: Cracked tooth #45.
Treatment Plan
Extraction of #45
Immediate implant placement at #45 site
Bone grafting for socket preservation and implant support
Healing abutment placement
Alternative treatment options including RCT → Post Crown → Crown discussed. Px elected for extraction and immediate implant replacement.
Pre-operative Assessment
CBCT reviewed.
IDN plotted and assessed.
Implant position and angulation planned.
Risks, benefits, limitations, replacement options, surgical procedures, and post-operative expectations explained.
Informed consent for extraction and immediate implant placement obtained.
Anesthesia
LA block administered to right IDN, LN, and LBN.
Surgical Procedure
Px cleaned and draped in sterile manner.
LA XAP #45 performed.
#45 fractured into 3 pieces during extraction.
Difficult but successful atraumatic extraction completed.
Socket curettage and haemostasis achieved.
Implant osteotomy prepared through extraction socket using implant drills.
4.5mm x 8.5mm Megagen Anyone Implant prepped with Megagen X-Active Plasma treatment and placed at #45 site.
Bone grafting performed using Dentium Osteon Collagen II Xenograft material.
6.5mm healing abutment placed to seal extraction socket.
No sutures required.
Haemostasis achieved.
POI given.
Post-operative Assessment
Post-operative CBCT taken.
IDN not involved.
Implant position and alignment satisfactory.
Bone graft adaptation dense and stable.
Px tolerated procedure well and left clinic in stable condition.