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Implant Erases Years of Unsuccessful Root Canals

Dr. Pioch

Dr. Raleigh Pioch of Pioneer Dental Group in Oregon City, Oregon, brings us another case study using the OsteoReady implant system:

Dr. Pioch details the case of a 63-year-old male patient who presented with a history of multiple root canal re-treatments and expressed his frustration with the failure of the treatment. The patient asked about the possibility of simply extracting the problem tooth and receiving an implant. As it turned out, the patient had received one of our practice's mailers featuring exam and implant promotions, which had precipitated his visit. Tooth #25 was the patient's chief complaint given the history of root canal failure, and he acknowledged further treatment needs. The patient opted for extraction of #25 with immediate or future implant placement, and an implant placement of #29.

On the day of surgery, I extracted #25. I laid a flap to remove all infected soft tissue and used a 2 mm drill to cut a pilot hole into fresh bone, placing an OsteoHybrid 3.75 x 11.5 mm implant sub-crestal to the adjacent alveolar bone. I packed BaseBone™ into the voids of the lesion around the implant, and placed a collagen resorbable membrane, completely covering the implant site and BaseBone graft with the membrane. To close, I sutured with multiple 4-0 chromic gut sutures, and placed the #29 implant. Just to be safe, I prescribed systemic antibiotics and chlorhexidine oral rinse. I re-scheduled the patient for a 2 week follow up, where we took a panorex and allowed the implant sites to heal for about four months.

After four months, I uncovered both implants and placed the abutments with 35 Ncm of torque. Both implants had osseointegrated well, and so I took impressions with the abutments in place, and sent them to the lab. I allowed the abutments to remain in the patient's mouth, sealed with Teflon® tape and Fuji II LC®. Crowns were delivered 2 weeks later, placed with no problems, and a very satisfied patient left my office with a new smile.

I accepted this case during my third month of placing OsteoReady implants, having placed about 60 prior to treating this patient.

Tooth #25 failed multiple endo retreatments.

Post 4 months healing with BaseBone®.

Exposure and abutment placed for impression.

Final restoration in place.