Ext, Graft, implant: Done🙌🏼
First picture is after atraumatic ext and the pilot hole drilled. Now to immediately place implant or to delay question is on all people’s mind, for me is all based on how each patient presents, it’s not a cookie cutter approach. So many factors in process before, their facial profile, buccal Wall present, extent of infection/trauma, smile line, gingival type, age and medical history etc. If I end up placing my implant I always anchor the palatal wall and start osteotomy 2-3mm below the palatal crest, 1 tip that I could give for these anterior cases I like to use my Occlusal Intraoral Mirror that I use for photography, it keeps me in check aligning with preferred angulation etc, I honestly use that mirror for all my crowns too make sure no undercuts/etc😜 Anyhow, i like to aim for the cingulum of the future crown and I visualize it in my mind as I do my osteotomy.
2nd picture is after I’ve done my osteotomy and usually for immediate cases I like to undercut my osteotomy for better initial stability, I put some bone grafting material such as corticocancelous mixed and use perio probe to position the graft on the facial of where my implant will land.
3rd picture is Our implant in place, for my anterior Implants currently I use custom abutment using Zirconia on a ti base as the abutment of choice and porcelain crowns.
questions are welcomed.... please direct your questions in comments below instead of DM so that more people can see and could learn what others do 😍🤗Peace 🦄
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