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Cosmetic Procedures Office Information
 Single-tooth Implant

Dental Implants can be used to replace a single tooth. Quite simply, the implant is placed and a single tooth prosthesis (an artificial tooth) is attached to the post.

Dr. Herman will perform the implant procedure and your restorative dentist will add the prosthesis.

A single tooth implant is the most natural looking way to replace a missing tooth.

Before Implant
After Implant

Maxillary Anterior Implants

Case # 1 The case was as follows: a 45 year old male presents with a chief complaint of "a problem with a root" and an interest in implant dentistry. He is a non-smoker and the medical history is negative.

The tooth is asymptomatic with a palatal probing depth of 6mm mid root. The probe "fell" into the root on the mid palate (Figure 1). Radiographic evaluation shows short / blunted roots with resorption # 9 and previous trauma confirmed (Figure 2). A flapless approach was decided upon and after atraumatic extraction, the buccal plate was evaluated and determined to be intact and the implant was placed (Figure 3). An Essex retainer was utilized for temporization at that time (today immediate temporization would be considered).

Figure 1 (Before)

Figure 2

Figure 3

A tappered implant was chosen to achieve better primary stability and obliterate the socket (Figure 3). After a sufficant healing period, indexing was done and the final restoration completed (Figure 4 is a 4 year radiograph / Figure 5 is a 4 year clinical photo). The case was restored by Dr. …..

Figure 4

Figure 5

Case # 2 The case was as follows: a 34 year old female presents with a chief complaint of "loose upper front teeth". Her medical history was non-contributory as it relates to dental treatment and she does not smoke.

Teeth 8-9 presented with a grade 2 mobility and normal probing depths (Figure 1). She had orthodontic therapy 5 years prior and stated the teeth were splinted but it kept breaking. Radiographic evaluation showed significant root resorption and a hopeless prognosis was given (Figure 2). Treatment options were reviewed and she opted for implant placement.

Figure 1

Figure 2

Figure 3

Extractions were performed, osteotomy initiated with 2mm twist drills and paralling pins placed (Figure 3). The difficulty in implant dentistry with maintaining the interproximal papilla pertains to the design of implants vs. the anatomy of the teeth at the CEJ. Anterior teeth have a CEJ with a rise and fall from mid root to the interproximals. Implants on the other hand are circular at its "CEJ" and therefore the interproximal bone wants to remodel and becomes flat interproximally. This in turn flattens out the papilla and leads to "black triangles".

The implants were placed at a depth and distance apart which would minimize this interproximal remodeling and help stabilize the interproximal soft tissue long term (Figure 4). The implant head design is an internal hex. If I was to do this case today a "platform switch" would also be utilized on the abutment to further protect and stabilize the crestal bone.

The 4 year follow up photo / pa is shown. Notice the stabilization of the interproximal bone and soft tissue (Figures 4 and 5). Dr….. provided the restorative dentistry in this case.

Figure 4

Figure 5

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