Immunodeficiency and Implant Placement?

Based on the limited diagnostic information you have provided, i do not see any reason why tooth #10 should be extracted. In regard to re- RCT, that is also a question. a short obturation by itself is not a justification for re-treatment. Keep in mind, sometime doing less is more. If you want to be certain of your diagnosis, take a CBCT if it is available, evaluate the periapical area for any pathology (which is negative on PA). If everything is OK do not re-treat the tooth. Make a longer Post Space ( it is too short now) make a nice Post that is long enough ( 9-10 mm) without enlarging the canal unnecessarily. Make sure you have adequate 2 mm ferrule circumstantially and Biologic Width is not violated. Have a nice crown fabricated and make sure you will remove all the excess cement, check and adjust the occlusion and i promise the tooth will last many years. Leave the fancy PRF & bone graft for when it is needed.

I agree with Dr PerioProsth.

I agree with the above. Some of her meds precludes implant treatment.

Hi, Not being funny, but if the only issue is the crown, why do an implant? Patient does not have Titanium deficiency. Fix the crown and go from there. Short crown can be fixed with Hard tissue crown lengthening. No need for implant unless Tooth is Hopeless, that's what I think about before doing an implant. Does Patient have any pain in the tooth? Is it fractured? My $0.02

I should add her general periodontal status is stable and she mas moderate restorations She also was of the belief that post core crown restoration would not last long term. Sometimes even as an experienced clinician patients try to get inside your head. If the tooth had to be extracted how would you proceed? Thanks for your comments.

Any clinical photos? Assuming that the tooth needs to be extracted and implant placed, there's no absolute contraindication for implant. However, I agree with all previous comments. Less is sometime the best treatment. Let's save teeth instead of rushing to take them out for implants. If that tooth is deemed hopeless for any reasons not mentioned above, then go for it

I agree with PerioProsth - I see no PA pathology - so why re do rct - ct scan would be helpful for final diagnosis - re-do the crown to achieve best esthetics.

This discussion parallels a very similar case presented about 2-3 months ago (except this one is even easier to do a crown on). It is really pleasing to see all the comments recommending saving the tooth. Of course the tooth is salvageable and should be saved – especially if there is some doubt as to an outcome with an implant. This needs to be carefully and calmly explained to the patient. My expectation would be that the tooth will last the patient’s lifetime (if the comments above are carried out). The only debate in my mind is whether to place a post or not. I have been placing short and very conservative posts for 45 years with great success. However some other colleagues do not place posts. That is the only issue to be decided I think.

The expression "less is more" …..would suit this situation. There are cases that people with Crohn's might have a sensitivity to Titanium Oxide....so placing an implant could be looking for trouble. The tooth seems to be stable both periodontally and endodontically.....just make a better post and core and do a new crown...she will be just fine.

First, you find out why that tooth got fractured. Look for overjet and overbite. If everything is within normal limits, it is prudent to save the tooth rather than extraction and placing an implant. Remember" Devans dictum". Let me know your treatment plan.

Re restore the tooth properly and consider alternative if and when the time comes !