Perio and Bruxism Consideration

A 68-year-old female with history of bruxism returns to clinic for discomfort in the upper left quadrant.  Exam shows that the tooth #14 has subgingival fractures.  X-ray reveals bone loss and calculus (Fig.1 >). 

After extraction, local scaling & root planing will be done (hand scalers).  Osteotomes will be used most likely.  If bone density is found to be high, use reamers instead.  Before bone graft is placed around the crest (Fig.2 red circles), apply Endogain on the root surfaces of the neighboring teeth.  If primary stability is achieved, place an abutment and fabricate an immediate provisional to prevent tooth shift.  No occlusal contact is allowed.  The missions are accomplished?

Return to Upper Molar Immediate Implant

Xin Wei, DDS, PhD, MS 1st edition 12/04/2014, last revision 12/06/2014