Gold Coated, Anatomically Prepared Abutment (M)

A 53-year-old man has perio-endo disease for the tooth #9 for 6 years (Fig.1).  In spite of scaling & root planing and root canal therapy. the tooth remains non-salvageable (Fig.2-4 (in chronological order)).  After Clindamycin socket treatment, place a long narrow implant (Fig.2) if the labial plate defect turns out to be extensive.  To reduce metal shadowing, use a gold coated abutment if available.  The margin of a stock (prefabricated) abutment is even.  In fact the crown/root (enamelocemental) junction is not even (waving), more apical buccopalatal than mesiodistal.  Choose a cemented abutment so that the margin is 1-2 mm below the papillae.  Then prepare the buccopalatal margin deeper, more or less anatomically. Re-prepare the margin if necessary before impression

Use hand and ultrasonic scalers to remove the residual calculus in the neighboring teeth after extraction (Fig.3 <).  The tooth #2 was lost due to periodontitis and should be replaced with an implant later on.

Take photos and PA immediately preop.

Return to Upper Incisor Immediate Implant Xin Wei, DDS, PhD, MS 1st edition 06/24/2016, last revision 12/22/2019