Surgical Removal of Retained Roots with Immediate Implant Placement and Bone Grafting at #24 & #25
Implant Placement
Chief Complaint
Patient requested replacement of retained roots at #24 and #25 with dental implants.
Clinical Findings
Retained roots at #24 and #25, caries-free.
Adequate ridge height and width for implant placement.
Assessment of #25 site: possible sinus lift if insufficient bone height noted.
Treatment Plan
Surgical removal of retained roots at #24 and #25.
Immediate implant placement at #24 and #25 sites.
Bone grafting with alloplastic grafting material around implant sites.
KIV sinus lift at #25 if indicated.
Pre-operative Assessment
Risks, procedures, and treatment plan explained.
Patient consented to proceed.
Patient cleaned, draped, and prepared under aseptic conditions.
Anesthesia
Local anesthesia infiltration at the 2nd quadrant.
Surgical Procedure
Incision made with buccal and palatal flap raised.
Surgical removal of retained roots #24 and #25 with bone guttering and sectioning; removed in 5 pieces.
Thorough curettage performed and granulation tissue removed.
Irrigation with saline.
Osteotomy sites prepared using implant drills through retained root areas.
Finalized implant sites after root removal.
Implant placement:
Dentium Superline 4.0 mm x 8.0 mm at #24 with 4.5 mm (M) healing abutment.
Dentium Superline 4.5 mm x 8.0 mm at #25 with 4.5 mm (M) healing abutment.
Bone grafting performed with Dentium Osteon II Collagen alloplastic bone graft (2 packs).
Primary closure achieved with 11 Surgipro™ polypropylene sutures.
Hemostasis achieved.
Post-operative Assessment
Post-op CBCT confirmed good implant alignment and positioning.
Bone graft appeared dense and well packed.
Patient satisfied with outcome.