More often than not and especially in emergency cases, patients are undecided about the method of tooth replacement they desire a the time of tooth removal. As a result extractions are done in a conventional manner and even with the utmost care bone defects can be created during the process of extraction. The natural process of bone resorption during healing after extraction can also make things even more complicated.
The case presented in the slideshow below is one where after the emergency extraction, the patient was given a removable partial denture also commonly called “flipper”. After a few weeks of wearing the flipper, the patient could no longer bear with discomfort of the flipper. After review of available options, the patient opted for a conservative, natural , metal free and non-removable method of tooth replacement. A zirconia crown supported by a ceramic dental implant which is also made of zirconia was selected to be the method of tooth replacement.
As part of our diagnosis and treatment planning protocol, a low radiation dental CT (CBCT) scan study of the area with the missing tooth was completed and it was discovered that as a result of the extraction and the loss of bone volume the site of implant placement was compromised. We were also able to determine the remaining bone density/quality, predetermine the exact volume of bone to reconstruct, select the accurate implant size and predetermine the crown shape. The exact location of the maxillary sinus floor was identified and assessed because maxillary sinus perforation can some times occur when implants are placed in the posterior upper jaw. With so much information gleaned from the dental CT scan we were able to safely and predictably place a zirconia dental implant and immediately seat a fixed temporary crown on the implant the same day it was inserted in the jaw.
After a bone integration period and soft tissue maturation of four months, the temporary acrylic crown was removed, impressions were taken and a permanent zirconia crown was fabricated and cemented to the implant.