Gingiva Island

A 78-year-old woman (SS) fractured root canal treated tooth #11 after upper frame-work partial denture fabrication.  Then the added on tooth and wrought wire fractured (Fig.1).  It appears that the best treatment will be immediate implant at #11 (Metronidazole) and addition of a wrought wire if necessary later on.  It was difficult to take PA with Sensor 2.  Take one with Sensor 1 when she returns for treatment.  There is an gingival island (Fig.2 *) between the two portions of the residual root.  Try to keep it, although it may be torn from one end.  Place a piece of Collagen Dressing underneath the island prior to bone graft.  If the labial gingiva has to be raised, make 2 distinct oblique incisions (Fig.3 black lines) to prevent laceration (Fig.7).  How to handle the immediate implant as related to Kennedy I removable partial denture?

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Xin Wei, DDS, PhD, MS 1st edition 06/24/2016, last revision 01/19/2018