Vertical Root Fracture Post RCT and Apicoectomy

Nine months post apicoectomy of the tooth #4 of a 40-year-old man (Fig.1 <), the root has vertical fracture (Fig.2).  It appears that the patient is a bruxer.  Place an implant as long as 18 mm (bone level, Fig.3).  Start osteotomy in the middle of socket, since there is bone resorption both buccally (apicoectomy) and palately (Fig.4 *).  The implant should occupy the meisodistal space for primary stability.  Measure root dimension post extraction to determine the implant diameter.  Use a 3.8 mm dummy implant.

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Xin Wei, DDS, PhD, MS 1st edition 09/23/2017, last revision 12/03/2018