case_images: PMC7704198_01
case_images: Preoperative clinical and radiographic presentation of tooth #21. (a) Intraoral frontal view shows associated gingival recession and an uneven incisal plane. (b) Periapical radiograph shows extensive root resorption affecting the coronal third of the root.
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case_images: fig1
case_images: He had a high smile line, uneven anterior incisal plane, and a class I incisal relationship (Figure 1(a)). Radiographically, tooth #21 was root canal treated, had communicating root resorption affecting the coronal third of the root, and interproximal, labial, and palatal bone resorption (Figure 1(b)).
case_images: GI subgingival "Imam matrix" that sealed the resorptive root defect.
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case_images: fig2
case_images: Once the GI had set, the paper points were removed from the canal and an access cavity was prepared to leave a 1 mm subgingival band of GI isolating the canal space from the surrounding tissue (fiber post drill; 3M) (Figure 2).
case_images: Clinical and radiographic presentation after orthodontic extrusion of tooth 21. (a) Intraoral frontal view showing the coronal relocation of the gingival margin and preservation of interdental papillae. (b) Periapical radiograph showing the coronal repositioning of the apex of the tooth and bone fill proximally.
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case_images: fig3
case_images: Clinical and radiographic images suggested sufficient formation of bone and soft tissue (Figures 3(a) and 3(b)).
case_images: Extracted tooth 21 with well-adapted deep margins of the provisional restoration.
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case_images: fig4
case_images: After achieving satisfactory nonsurgical bone and soft tissue augmentation around tooth #21, the patient was referred back to his periodontist for atraumatic extraction of the tooth (Figure 4) and immediate implant placement (Keystone, Lifecore) and loading with a provisional crown (Figures 5(a) and 5(b)).
case_images: Clinical and radiographic presentation of the immediately placed implant with provisional restoration for tooth #21. (a) Intraoral frontal view. (b) Periapical radiograph.
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case_images: fig5
case_images: After achieving satisfactory nonsurgical bone and soft tissue augmentation around tooth #21, the patient was referred back to his periodontist for atraumatic extraction of the tooth (Figure 4) and immediate implant placement (Keystone, Lifecore) and loading with a provisional crown (Figures 5(a) and 5(b)).
case_images: Postoperative clinical presentation of the definitive implant-supported crown of tooth 21.
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case_images: fig6
case_images: Six months later, a definitive screw-retained zirconia crown was fabricated (dynamic abutment solution) (Figure 6).