Infection, Immediate Implant, Bone Graft and Immediate Crown (One-Hour Tooth)
Mr. Su has severe gum disease. One of his top front teeth is loose. The bone around the root is gone (Fig.1 *). The overlying gums are reddish (Fig.2 *). The only solution to the infection is to take out the tooth (Fig.7: lots of tartar on the root surface). For cosmetic reason, an implant is placed immediately (Fig.3,4). An abutment (like a post) is immediately inserted into the implant (Fig.5). However, the gums collapse over the implant (Fig.3,5 *) due to bone loss mentioned above. The collapse is fixed by reusing bone saved during implant placement and artificial bone (mainly calcium, Fig.6 *). Finally a temporary crown is made and cemented. When the patient leaves the dental office, he has one solid tooth. Although some of photos look bloody, Mr. Su is doing very well after surgery.
Fig.8,9 show the temporary (provisional, P) crown one week after restoration. The gums are healthy (not reddish, as compared to Fig.2) and normal in shape (not collapse before bone graft (compare to Fig.3,5).
To fight the infection, the patient starts to take an antibiotic one to two days before surgery and several days afterwards. Mr. Su has maintained his oral hygiene very well since being our patient. This is the third implant in his mouth. He is doing great after every implant placement. The temporary crown will be changed to the permanent one in 4-6 months.
Xin Wei, DDS, PhD, MS 1st edition 08/29/2013, last revision 09/07/2013