Dentaltown September 2016 - 30

oral surgery message board Implant into Root Tip? Before a Townie begins a planned restoration, he needs advice on whether a radiograph shows a root tip, or residual gutta percha from the previous tooth. Dentaltown.com > Message Boards > Implantology > Implant into Root Tip? FUDstu Member Since: 04/18/10 Post: 1 of 123 Related Message Boards A Surprise Root Tip to Make Things More Interesting SURPRISE ROOT Implants and Root Tips IMPLANTS ROOT The patient presented with this three months after the implant was placed by an oral surgeon. The area of concern is what looks like remnant gutta percha from the previous tooth that the oral surgeon said he extracted prior to implant placement. The patient was referred back to the surgeon for a CT scan of the area to determine-if possible-if that is residual gutta percha or indeed a root tip. The surgeon saw no need for a CT scan and said it was simply gutta percha. I'd like any opinions from this forum. My plan is to send the patient for a CT scan and second opinion. The planned restoration is a three-unit bridge using implants at sites #20 and #18 as abutments. If #20 fails, so does my entire restoration. 6/8/2016 drwillie Member Since: 10/14/02 Post: 2 of 123 If you're talking about that little radiopaque spot just mesial to the apex of the implant, I'd say it was GP. With scatter from the implant when you get a CBCT, you might not even be able to see it. 6/8/2016 FUDstu Member Since: 04/18/10 Post: 3 of 123 Do you see the vertical radiopacity to the mesial of the implant just above that spot? Do you think the CT scan would not even pick up that much gutta percha? 6/8/2016 jradds7 Member Since: 04/11/03 Post: 5 of 123 Tough one. I don't know for sure, but I feel like I'm seeing a faint PDL. In my opinion, I would absolutely get a second opinion/CBCT. I would at least present the patient with the possible scenarios. If it is in fact a root tip, then the whole bridge will be toast and it will not be redone at no charge. This is one of those situations where 2-D X-rays just aren't perfect enough to make a determination. Although maybe if you took a few PAs at different angulations you might have a better idea what you're looking at. As an aside: That abutment isn't anywhere close to being seated, right? Or is that some funky new type of platform switch? 6/8/2016 dr_mike Member Since: 05/29/03 Post: 9 of 123 This case has issues. Get a second more angled X-ray. Might be able to see more. Why was the abutment placed so improperly? I would remove it ASAP. The implant placement seems off, it's very deep. This for sure will need custom abutment. 6/8/2016 SkiDoc Wade Member Since: 03/26/03 Post: 11 of 123 Looks fine. I wouldn't worry about it if it's integrated and tissue looks good. Could be an issue but so can a lot of other factors. Not ideal but I would restore and monitor. 6/8/2016 Continued on p. 32 30 SEPTEMBER 2016 // dentaltown.com http://www.dentaltown.com/MessageBoard/thread.aspx?a=11&s=2&f=123&t=272789 http://www.Dentaltown.com http://www.dentaltown.com/MessageBoard/thread.aspx?a=11&s=2&f=123&t=267529 http://www.dentaltown.com/MessageBoard/thread.aspx?a=11&s=2&f=123&t=272789 http://www.dentaltown.com

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