The CBCT scan evaluation was decisive to diagnose the tooth as hopeless. Different treatment options were presented to the patient who chose the option of tooth extraction and immediate implant placement with immediate provisional crown. This way his social and professional activities would not be compromised after the surgical intervation, which it would be the case if conventional workflow would have been chosen.
Even though it was not meant to use a restrictive surgical guide, Intra oral scanning was performed in order to initiate the production of a tridimensional surgical reference guide, as well as to transmit the necessary information to the dental laboratory to produce the hollow temporary crown ahead of time for the surgery. The implant of choice was the new Straumann(r) TLX with the diameter of ø 3.75 x 12mm length meant to be placed in flapless approach immediately after the extraction and an immediate provisional crown delivered after the implant placement. After a period of 3 months a full zirconia crown was planned to finalize the case.
Under local anaesthesia, the extraction of tooth #14 was performed by dissecting the roots int two parts in the medio-distal direction using a diamond bur. Gentle movements were applied using micro elevators to remove each part individually preserving alveolar bone and surrounding soft tissues(Fig. 4, 5, 6).