PMC7647738_01
Image of the roots before the treatment.
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A 50-year-old man was referred to us having a decemented bridge from 1.2 to 2.2, with inadequate ferrule and metal posts in each root (1.1 and 2.2), both fractured (Figures 1 and 2).
Periapical X-rays of the 4 incisive roots.
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A 50-year-old man was referred to us having a decemented bridge from 1.2 to 2.2, with inadequate ferrule and metal posts in each root (1.1 and 2.2), both fractured (Figures 1 and 2).
Intraoperative image of the root shield's preparation after extraction.
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The socket shield technique was performed on central incisors and pontic shield on lateral incisors (Figure 3) in order to minimize resorption and reshaping of the bone crest in implants and pontics.
Intraoperative image of the implants placed, not being in contact with the buccal surface of the roots.
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Haemostatic collagen sponges were placed both in 1.2 and in 2.2, and immediate implant placement was performed in 1.1 and 2.1 (Figures 4 and 5).
Postoperative periapical X-ray, taken immediately after implant placement.
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Haemostatic collagen sponges were placed both in 1.2 and in 2.2, and immediate implant placement was performed in 1.1 and 2.1 (Figures 4 and 5).
One-week follow-up.
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After one week, healing was proper (Figure 6).
Three-month follow-up, after implant placement.
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Three months after, the osseointegration of the implants was corrected (Figure 7), but teeth 1.1 had a superficial exposure of the shield (Figure 8), which was reshaped with the high-speed handpiece using a diamond bur, without needing anesthesia.
Shield exposure on 1.1 implant.
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Three months after, the osseointegration of the implants was corrected (Figure 7), but teeth 1.1 had a superficial exposure of the shield (Figure 8), which was reshaped with the high-speed handpiece using a diamond bur, without needing anesthesia.
One-month follow-up, after high-speed handpiece reshaping of the shield exposure on 2.1.
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After one more month, the clinical appearance was corrected (Figure 9) and a partial fixed denture was screwed at 30 N/cm to the implant (Figures 10 and 11).
Final bridge delivery.
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After one more month, the clinical appearance was corrected (Figure 9) and a partial fixed denture was screwed at 30 N/cm to the implant (Figures 10 and 11).
Control X-ray after bridge placing.
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After one more month, the clinical appearance was corrected (Figure 9) and a partial fixed denture was screwed at 30 N/cm to the implant (Figures 10 and 11).
Clinical lateral vision. A good maintenance of the buccal thickness is seen.
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Good maintenance of buccal volume and natural appearance is seen (Figure 12).