A patient whose old crown had come away because of decay underneath

[The fractured tooth]

This patient came in after an old crown had come away because of decay underneath. At a glance it looks as though some tooth structure remains, but once all the decay is removed there is really very little left. Where a medical condition rules out implant surgery, or where the patient strongly wishes it, one can try to save the tooth by removing the decay and building a post — but how long it would last is uncertain. After discussing it with the patient, we decided here on extraction with immediate implant placement.

[Sectioned into two pieces for removal]

With immediate placement, the tooth has to come out with as little damage to the surrounding bone as possible, so extraction technique matters a great deal. To remove it without harming the surrounding tissue, the tooth was sectioned into two pieces as shown and eased out carefully before the implant was placed. Because no gum incision is made, there is almost no bleeding afterwards and recovery is quick. The treatment is completed with the restoration about two months later.

[The mouth immediately after implant placement]

[Before vs after implant placement]