Patient came in concerned about her 11 and 22. Both had periapical pathology and she was against root canal therapy on the basis that “infection might spread around her body”.
We had a lengthy chat about her aims, which were to keep her teeth.
Also had talk about the constant breakdown of her other teeth and how to avoid that.
We investigated the tooth under LA and then extracted and grafted. I decided that whether we did an implant, or a fixed partial denture, we would need to maintain tissue volume.
I raised flap because I find it very difficult to properly debride a socket without a flap, and failure to properly debride will result in infection of the graft.
After discussing the fact that the patient had infection in her jaw for such a long time, we both came to the conclusion that she was not likely to have as much infection with root canal therapy, and perhaps saving her tooth would be better. So will probably do RCT on the 22 next week.
Patient presented requesting removal of the 11
Buccal and palatal anesthesia to investigate
Tooth unrestorable. 5mm subgingival on the distal
Mectron piezo with diramond tip for further debridement on the socket
Bone defect cleaned with normal currettes first
Bio-Oss. Was covered with two layers of Bio-Gide. Socket slightly overfilled
Mucoseal to avoid advancing flap. The flap is actually held with two vertical matress and then the mucoseal sutured separately. I find that when I advance a flap, the tissue never looks any good.
Extraction, graft and bone augmentation completed with a review in one week.
The purpose of this blog is to help fellow dentists.
Disclaimer: Dr Lincoln Harris has no economic interests with any company referred to in this or other blogs on this website. All dentistry, surgery and photography by Dr Lincoln Harris is with patient permission. Individual results may vary. Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.
Dr Lincoln Harris has been completely focused on excellence and quality from the beginning of his career as a dentist. He established the first private dental practice in Bargara – Harris Dental Boutique in 2000. Since graduation he has trained extensively in Aesthetic Implant Techniques and Full Mouth Rehabilitation to attain immense skill and knowledge. With his vast dental knowledge Dr Harris coaches and trains dentists from all over the world on complex aesthetic dentistry, surgical techniques and business management. Dr Harris is the founder of RIPE. Restorative Implant Practice Excellence: Full Protocol group an international forum of over 70,000 members worldwide. The purpose of the group is to share information and excellence in the dental industry. He has also lectured in multiple cities throughout Australia, North America, Asia, Singapore, United Kingdom and Europe.