Possible Labial Plate Defect

A 48-year-old woman (DC) presented to clinic with chief complaint "loose tooth after accident".  The tooth #9 appears extruded (Fig.1 arrow) with large bone resorption (*) and mobility III .  The labial plate may be defective.  If the defect is extensive (take photos) and confirmed after extraction (Metronidazole), draw blood for PRF.  If the lady turns out to be skinny with a small root (to be measured), place a smallest 2-piece implant with 15 mm long or longer (Fig.2).  Underprepare and/or use larger implant if the bone is not dense.  Check overbite and overjet.  Be cautious in fabricating an immediate provisional if the local occlusion is abnormal.  In fact there are several missing teeth, which makes the immediate provisional precarious (risky).  Provide ample occlusal clearance.  Tell the patient to complete other dental treatment as soon as possible.  Pack bone graft in step to prevent periimplantitis.

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Xin Wei, DDS, PhD, MS 1st edition 05/13/2016, last revision 01/19/2018