I have treatment planned #27 for extraction and replacement with an implant. It has a root fracture with 10mm pocket and is hopeless and needs to be extracted. The tooth has been symptomatic, but I have been able to control the symptoms with antibiotics. The alveolar ridge there is knife edged and inclined to the lingual. The periodontal status of the adjacent teeth is chronic Type I periodontal disease with 4-5mm pockets. How do I manage the knife edge ridge so I can place an implant and maintain the existing normal gingival architecture? The bony architecture is normal. Will this require bone augmentation? I maybe wrong about this, but I thought that you can only modify mandibular alveolar crest architecture temporarily and that it will revert to its pre-surgical state over time. Is that accurate? The adjacent teeth would be very poor abutments for a bridge to replace the canine. Should the implant be placed immediately at sufficient depth to allow for complete encapsulation in bone? Will the gingival architecture remain in place or recede? Any other ideas on the best way to manage this case?
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