Case Study – Immediate implant to replace central incisor

Initial Situation

This lady has been a patient of Dr Barry Phelan since 2011. During the initial consultation it was noted that the patient was a bruxer (teeth grinder). A mouthguard was prescribed but declined by the patient.

This central incisor had been treated years prior with root canal treatment, post, core and crown placement.

Due to the para functional bite force applied and the fact that the tooth had been greatly weakened from previous treatment, the tooth fractured at the gumline. The tooth had an unfavourable prognosis and required extraction.

The Treatment Plan

Dr Barry Phelan took the time to outline the issues to the patient and provided her with a comprehensive treatment plan that addressed all of the issues. The patient was able to take the treatment plan away and consult with her family members to make a decision about the course of treatment.

The patients decided to proceed with the recommended treatment plan that consisted of the following:

  • Extraction of the fractured tooth with immediate implant placement
  • Placement of a screw retained temp crown on the day of surgery. This picture shows the surgery one week post operation with a beautiful response around the soft tissue
  • After 3 months of healing we took impressions of the implant. Our laboratory technician (RWD Dental Imaging, Bondi Junction) fabricates the final crown. Using a highly skilled local technician allows us to achieve restorations that can blend seamlessly with the natural teeth.

The Outcome

The patient was very happy with the outcome of the dental treatment. Having an immediate implant placed compared with traditional implant placement, meant that the patient was able to have a temporary restoration fixed to the implant. There was no need for removable dentures for the duration of the treatment.

Although the patient was unable to chew on this tooth for 3 month due to healing time, the quicker treatment timeframe was more convenient for the patient both from a comfort and time perspective.

The immediate placement of the implant also allowed for better maintenance of the soft tissue and bony architecture around the neck of the crown. This is crucial in giving the tooth such a natural appearance.

NOTE: Not all situations allow for immediate implant placement and certain clinical criteria needs to be met before advancing to each subsequent stage.