Australasian Dentist Issue 89

Category AustrAlAsiAn Dentist 107 proFIle Figure 1 Figure 3 Figure 4 Figure 5 Figure 2 Patient history: Patient is a 39 years old female with no significant medical history. she presented with pain on the lower left molar. 36 had a large MODB composite resin restoration. Diagnosis: When evaluated with the crack finder, there was a suspected crack in the 36. root canal treatment was initiated. Crack extending below the alveolar bone in the distal root was observed. the tooth was determined to have poor prognosis. CBCt was taken with Vatech – PaX-i sMArt. there was adequate bone width and height. Treatment plan: Various treatment options of extraction, denture, bridge and implants were discussed with the patient. Patient agreed to have the tooth extracted followed by immediate implant placement. After extraction, immediate implant with Dentium superline implant (5.0 x 10mm) was planned with Bio-Oss. Final restoration was planned to be fabricated as zirconia screw-retained crown using customized abutment. Procedure: Atraumatic extraction was performed by sectioning the tooth. undersized osteotomy was performed as an immediate implant First molar replaced with Immediate Dentium Superline By Dr David Jang, BDsc (uQ) Principal Dentist Canada Bay Dental was going to be placed. Dentium superline implant 5.0mm x 10mm was placed. it was placed so that the implant was in contact with the lingual wall, firstly to increase initial stability, and secondly to reduce the number of wall defect. initial stability of 40ncm was achieved. the jumping gap was grafted with Bio-Oss and then a 6.5mm diameter healing abutment was connected. Patient was reviewed at 1 week and 2.5 weeks. isQ was measured with Penguin 7 weeks after the surgery. 79 was measured, so good osseointegration was determined to have taken place. scan was taken with trios 3 scanner and screw-retained zirconia crown was fabricated using customized abutment. this was delivered and the patient was satisfied with the result. Conclusion: immediate implant is a predictable procedure especially for lower molars if there is sufficient distance to the inferior dental nerve. With undersized osteotomy and careful selection of implant, immediate implant will shorten the treatment duration and achieve satisfactory results. Dr David Jang CANADA BAY DENTAL Suite 3, 10 Market Street Breakfast Point NSW 2137 Ph: (02) 9743 5744