Mesiobuccal Root Fractures

A 58-year-old lady (CG) reports gingival recession of the upper right 1st molar with bad smell (Fig.1 (panoramic X-ray): #3).  It appears that the mesiobuccal root has vertical fracture (black *: distal portion of the root; white *: displaced mesial one, Fig.2 (PA)).  Clinically, the MB root is exposed with soft and hard tissue defect.  After extraction, socket debridement and Clindamycin soaking, a 5.3x12 mm implant will be placed with a possible 7.8x4(2) mm abutment (Fig.3).  Mixture of autogenous bone, allograft and Osteogen is to be placed in the remaining socket, especially MB.  A gingiva graft will be harvested from the palate to MB.  Collagen plug will be placed in the donor site with suture fixation.  If primary stability is satisfactory, an immediate provisional is to be fabricated to hold the bone graft and membrane in place.

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Xin Wei, DDS, PhD, MS 1st edition 12/22/2015, last revision 12/25/2018