Immediate Implant Placement at Tooth #15 Following XAP for Recurrent Caries to Pulp
Surgical Procedure
Chief Complaint
Pain and discomfort from tooth #15 with known recurrent decay under existing restoration.
Clinical Findings
Tooth #15 with large MOD leaking tooth-coloured restoration.
Recurrent caries extending to the pulp.
Periapical radio-opacity noted.
CBCT reviewed: implant site favourable; maxillary sinus not involved.
Treatment Plan
Option 1:
Root canal treatment → Post & Core → Crown
Option 2:
Extraction (XAP) → Immediate implant placement at #15
Bone grafting and temporary restoration (temporalization)
Patient elected Option 2.
Pre-operative Assessment
CBCT taken and reviewed.
Final implant position and angulation planned.
Risks, benefits, and procedure explained.
Informed consent for implant placement obtained.
Anesthesia
Local anesthesia administered. Patient cleaned and draped.
Surgical Procedure
Atraumatic XAP of #15 using minimally invasive techniques.
Bone fully preserved.
Implant site prepared using implant drills and osteotomes via fresh extraction socket.
Dentium Superline 4.0 mm × 12.0 mm implant placed.
Bone grafting with 1.0 cc EthOss alloplastic graft material.
Temporalization using titanium temporary abutment + composite resin to seal the socket and protect graft.
Hemostasis achieved.
Post-operative CBCT taken confirming good implant position and alignment.
Post-operative Assessment
Maxillary sinus not involved.
Implant stable, alignment satisfactory.
Patient comfortable and satisfied with outcome.
Post-operative instructions given.