Immediate Molar

Mrs. Ni (in her forties) has had history of sinusitis.  In the last 6 months she has had toothache in a molar on the top without obvious reason.  CT scan (Fig.1) shows that the molar labeled as #3 has a root tip infection  (>).  The sinus membrane is particularly thick (*), as compared to that on the opposite side (above the tooth #14).  Finally the molar #3 cracks (Fig.2 ^).  It should be extracted immediately and replaced by an implant (Fig.3 I, replacing the root of the tooth) at the same time.  Since this tooth is pretty far in the back, we do not plan to make the new tooth (crown) for her right away.  But she is especially scared of going out without this back tooth.  To satisfy her wish, we place an abutment (like a post, A in Fig.4) and make a temporary crown in the same appointment (Fig.5 T).  The molar tooth has a very large socket (Fig.4 arrowheads).  Even though the implant just placed is large (I), there is a gap surrounding the implant.  The temporary crown in fact closes the wound completely (Fig.5).  The latter heals well 7 days after surgery (Fig.6).  Mrs. Ni has no discomfort.  She is very grateful.  One year after surgery, Mrs. Ni can chew normally without sinus infection (Fig.7 *, as compared to Fig.1).

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Xin Wei, DDS, PhD, MS 1st edition 08/28/2014, last revision 05/11/2016