Dentaltown December 2021 - 46

Case study
The hygienist detected an external
invasive root resorption lesion on tooth #21
when the patient was in for periodontal
maintenance (Figs. 1 and 2). A CBCT
was taken after examination to determine
the extent of the lesion to aid in treatment
planning. Unfortunately, this particular
lesion (Fig. 3) was too large to be treated
and necessitated extraction.
Initially, we discussed the possibility of
orthodontic treatment to close the space or
an implant to replace the tooth. The patient
had a good experience with an implant in
the past, so she elected that option. We
outlined a routine plan of extraction, time
allowed for healing, implant placement,
time allowed for osseointegration and then
restoration of the implant.
Before the extraction of #21, we imaged
the patient in Cerec Ortho, which allows
for full-arch scanning and bite registration,
so we could print a 3D model and use it to
ultimately copy her existing tooth shape
into the final implant restoration. We were
not planning on a provisional; however, if
this had been an anterior tooth, we would
have used the 3D-printed model to make
a positive pressure thermal plastic on the
MiniStar for the extracted tooth to be placed
into and worn as a provisional.
Having a digital impression not only
makes this process more accurate than
alginates, but it is also much easier and less
stressful because you don't have to worry
about the stone model breaking when you
take off the thermal plastic retainer. The
3D-printed models very rarely fracture, and
if they do, you simply print another one. It
is not unusual for patients to require more
than one thermoplastic provisional during
the time between the extraction and the
final implant restoration, so having the
ability to easily make this with no additional
chair time is ideal. The digital impression
and 3D-printed model are also useful in
planning the implant placement and making
the surgical guide.
46 DECEMBER 2021 // dentaltown.com
For this patient, the extraction was
straightforward. We had some concerns
with her lack of keratinized tissue, but we
continued to monitor it. The surprise came
when preparing for implant placement and
Fig. 1
it was found that tooth #20 had moved
mesially 1.5 mm, leaving a large open contact
at #19-20 and not leaving enough space for
an implant at #20 (Fig. 4).
Fig. 2
Fig. 3
Fig. 4: Surprise finding of Tooth #20 moving
mesial into the implant site position after the
extraction of #21.
http://www.dentaltown.com

Dentaltown December 2021

Table of Contents for the Digital Edition of Dentaltown December 2021

Howard Speaks: Making a Different Kind of 5-Year Plan
Professional Courtesy: The PPO Pay Cut
Continuing Education Update
Poll: Clinical Technology
Message Board: Trying to Push Myself and Pushed Myself Too Far.
Message Board: Worn Dentition, Composite Rehab
Office Visit: Dr. Ross Oberschlake
Let's Get Digital — Dr. Robin Henderson
Seeing Is Believing — Dr. Kristen Andrews
Ad Index
The Rules of the Game — Jay Geier
2021 Dentaltown Townie Choice Awards
Dentaltown December 2021 - 1
Dentaltown December 2021 - Cover1
Dentaltown December 2021 - Cover2
Dentaltown December 2021 - 1
Dentaltown December 2021 - 2
Dentaltown December 2021 - 3
Dentaltown December 2021 - 4
Dentaltown December 2021 - 5
Dentaltown December 2021 - 6
Dentaltown December 2021 - 7
Dentaltown December 2021 - 8
Dentaltown December 2021 - 9
Dentaltown December 2021 - Howard Speaks: Making a Different Kind of 5-Year Plan
Dentaltown December 2021 - 11
Dentaltown December 2021 - Professional Courtesy: The PPO Pay Cut
Dentaltown December 2021 - 13
Dentaltown December 2021 - Continuing Education Update
Dentaltown December 2021 - 15
Dentaltown December 2021 - Poll: Clinical Technology
Dentaltown December 2021 - 17
Dentaltown December 2021 - 18
Dentaltown December 2021 - 19
Dentaltown December 2021 - Message Board: Trying to Push Myself and Pushed Myself Too Far.
Dentaltown December 2021 - 21
Dentaltown December 2021 - 22
Dentaltown December 2021 - 23
Dentaltown December 2021 - 24
Dentaltown December 2021 - 25
Dentaltown December 2021 - Message Board: Worn Dentition, Composite Rehab
Dentaltown December 2021 - 27
Dentaltown December 2021 - 28
Dentaltown December 2021 - 29
Dentaltown December 2021 - Office Visit: Dr. Ross Oberschlake
Dentaltown December 2021 - 31
Dentaltown December 2021 - 32
Dentaltown December 2021 - 33
Dentaltown December 2021 - 34
Dentaltown December 2021 - 35
Dentaltown December 2021 - 36
Dentaltown December 2021 - 37
Dentaltown December 2021 - 38
Dentaltown December 2021 - 39
Dentaltown December 2021 - 40
Dentaltown December 2021 - 41
Dentaltown December 2021 - 42
Dentaltown December 2021 - 43
Dentaltown December 2021 - Let's Get Digital — Dr. Robin Henderson
Dentaltown December 2021 - 45
Dentaltown December 2021 - 46
Dentaltown December 2021 - 47
Dentaltown December 2021 - 48
Dentaltown December 2021 - 49
Dentaltown December 2021 - 50
Dentaltown December 2021 - 51
Dentaltown December 2021 - Seeing Is Believing — Dr. Kristen Andrews
Dentaltown December 2021 - 53
Dentaltown December 2021 - 54
Dentaltown December 2021 - 55
Dentaltown December 2021 - 56
Dentaltown December 2021 - Ad Index
Dentaltown December 2021 - The Rules of the Game — Jay Geier
Dentaltown December 2021 - 59
Dentaltown December 2021 - 60
Dentaltown December 2021 - 61
Dentaltown December 2021 - 62
Dentaltown December 2021 - 63
Dentaltown December 2021 - 2021 Dentaltown Townie Choice Awards
Dentaltown December 2021 - 65
Dentaltown December 2021 - 66
Dentaltown December 2021 - 67
Dentaltown December 2021 - 68
Dentaltown December 2021 - 69
Dentaltown December 2021 - 70
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Dentaltown December 2021 - 80
Dentaltown December 2021 - Cover3
Dentaltown December 2021 - Cover4
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