case_images: PMC5902076_01
case_images: The remaining roots in teeth 1.4 and 1.5 presented decay and exposed endodontic treatment. Tooth 1.6 had an extensive crown restoration and deep, subgingival distal decay.
case_images: CRID2018-6412826.001.jpg
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case_images: fig1
case_images: The dental team performed a clinical examination (Figure 1) and a radiographic study (Figures 2(a) and 2(b)) on the patient detecting decayed remaining roots in teeth 1.4 and 1.5 and performed an extensive restoration presenting deep, subgingival distal decay on tooth 1.6.
case_images: (a) Preoperative radiograph. (b) Upper maxillary CBCT of Tooth 1.6.
case_images: CRID2018-6412826.002.jpg
case_images: PMC5902076_01_CRID2018-6412826.002.jpg
case_images: fig2
case_images: The dental team performed a clinical examination (Figure 1) and a radiographic study (Figures 2(a) and 2(b)) on the patient detecting decayed remaining roots in teeth 1.4 and 1.5 and performed an extensive restoration presenting deep, subgingival distal decay on tooth 1.6.
case_images: Implant paralleling pin inserted after interradicular bone drilling.
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case_images: fig3
case_images: Once the roots were clinically visible, the drilling sequence recommended by the implant manufacturer was performed through the tooth, always corroborating the drilling direction with a paralleling pin (Figure 3).
case_images: Remaining root aspects were carefully extracted using desmotomes.
case_images: CRID2018-6412826.004.jpg
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case_images: fig4
case_images: When the drilling sequence was completed, the remaining root fragments were carefully removed using desmotomes (Figure 4).
case_images: Immediate implant placement of an Alpha Bio ICE 5.3 x 10 mm implant in fresh extraction socket.
case_images: CRID2018-6412826.005.jpg
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case_images: fig5
case_images: Tarnow classification (Figure 5). To promote a nonsubmerged healing approach, a standard healing abutment of 4.6 mm of diameter and 4 mm of length (Alpha Bio, Alpha Bio Tec.) was connected to the implant. The 3 mm horizontal gap between the implant and the bone walls was filled with a xenograft (Alpha Bio's Graft, Alpha Bio Tec.) Finally, platelet-rich fibrin (PRF) membranes were fixed through a monofilament nylon blue suture No. 5/0 (Tagum 2/0 HR25, Tagumedica S.A.). Additionally, Alpha Bio ICE 3.7 N x 10 mm implants were placed in teeth 1.4 and 1.5 (Alpha Bio Tec.) (Figure 5).
case_images: Closure using a 5.0 nylon suture.
case_images: CRID2018-6412826.006.jpg
case_images: PMC5902076_01_CRID2018-6412826.006.jpg
case_images: fig6
case_images: At this time, the gingival architecture remained stable with preservation of a functionally attached gingiva (Figure 6). At 6 months and 12 months follow-ups, clinical and radiological exams showed that the bone levels remained stable (Figures 7 and 8).
case_images: Follow-up at 6 months.
case_images: CRID2018-6412826.007.jpg
case_images: PMC5902076_01_CRID2018-6412826.007.jpg
case_images: fig7
case_images: At this time, the gingival architecture remained stable with preservation of a functionally attached gingiva (Figure 6). At 6 months and 12 months follow-ups, clinical and radiological exams showed that the bone levels remained stable (Figures 7 and 8).
case_images: Prosthetic delivery radiograph.
case_images: CRID2018-6412826.008.jpg
case_images: PMC5902076_01_CRID2018-6412826.008.jpg
case_images: fig8
case_images: At this time, the gingival architecture remained stable with preservation of a functionally attached gingiva (Figure 6). At 6 months and 12 months follow-ups, clinical and radiological exams showed that the bone levels remained stable (Figures 7 and 8).
case_images: One-year follow-up.
case_images: CRID2018-6412826.009.jpg
case_images: PMC5902076_01_CRID2018-6412826.009.jpg
case_images: fig9
case_images: In addition, the prosthetic structure remained in optimal clinical condition, displaying optimal esthetic and functional results (Figure 9).