Missing maxillary central incisor: thoughts?

Last Updated: Oct 23, 2017

My patient is missing the maxillary central incisor. The incisive canal is very large and is situated to the lingual. There is only 3.19mm between incisive canal and lateral incisor. Buccolingually, there is only 4.76mm bone labial to the incisive canal area. Placing a single implant in the maxillary central site may not be a good option. Another plan would be to extract the lateral incisor and cantilever the central incisor. A bridge from the lateral incisor to the other central is not an option since it is already and implant and the patient does not want to remove the crown. Any other options to restore this case?

6 Comments on Missing maxillary central incisor: thoughts?

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Craig Thiede

10/23/2017

Another option is to remove the anterior palatine nerve and graft the canal. This will take a fair a mount of bone. Then you can place the implant.

Pakan

10/23/2017

I would clean the incisive canal area and graft it. You then can place the implant without removIng lateral incisor

Gary Greenstein

10/23/2017

I suggest you read this article. Cavallaro J, Tsuji S, Chiu TS, Greenstein G. Management of the Nasopalatine Canal and Foramen Associated With Dental Implant Therapy. Compend Contin Educ Dent. 2016 Jun;38(6):367-372; quiz 374. PubMed PMID: 28570082.

Steven A. Guttenberg, DDS

10/23/2017

You have not posted the associated radiographic images. CBCT would be best and most useful for further discussion. If the canal is very large, as you describe, perhaps it is actually an incisive canal cyst that you are viewing.

DR ANUJ CHHABRA

10/24/2017

Kindly post images(clinical and radiographic) for better understanding and suggestions

Re O'Neill

10/24/2017

You have posted some detailed measurements for your case that you are having issues with planning but please share the CT imaging data so we can all help. Just under 5mm of available bone width sounds just fine but we would all like to see imaging.

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