Missing maxillary central incisor: thoughts?

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 thoughts on “Missing maxillary central incisor: thoughts?

  1. Pakan says:

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

  2. Gary Greenstein says:

    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, MD says:

      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.

  3. Re O'Neill says:

    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.


Comments are closed.

Posted in Clinical Questions, Restorative.
Bookmark Missing maxillary central incisor: thoughts?

Videos to Watch:

Single Tooth Replacement with Implants in the Esthetic Zone

Dr. Jack Hahn provides tips and reviews cases for implant placement in the esthetic zone.[...]

Watch Now!
Surgical Consideration for the Flapless Approach

In this video, Dr. Jack Hahn discusses and presents cases to review the surgical considerations[...]

Watch Now!
Bond Apatite: Socket Preservation Cases

These 2 videos show the use of Bond Apatite in socket preservation cases, one with[...]

Watch Now!
3D Guided Implant Placement

The placement of multiple implants in this case was helped thru the use of 3d[...]

Watch Now!
Ridge Splitting Cases in Narrow Alveolar ridge

This videos shows ridge splitting, which when combined with bone expansion, is an effective technique[...]

Watch Now!
Placement of 4 Implants and Cement-Retained Bridge

The treatment plan was to extract the lower incisors, canines, and lower premolar and place[...]

Watch Now!
Failing Bridge Replaced with Dental Implant Supported Bridge

Ahe patient presented with a failed dental bridge from the upper right canine to the[...]

Watch Now!
Lateral Sinus Augmentation with CGF

Following membrane elevation with the lateral approach, and confirmation of an intact sinus membrane, concentrated[...]

Watch Now!
Titanium Mesh for Ridge Augmentation

The use of titanium mesh is a reliable method for ridge augmentation to provide adequate[...]


Watch Now!
Implant Grafting Techniques: Demineralized Sponge Strip and Tunneling

This video reviews several unique grafting and surgical techniques, including the use of demineralized cancellous[...]

Watch Now!
Mandibular Fixed Screw Retained Restoration

This video shows the use of a surgical guide for a mandibular fixed screw retained[...]

1 Comment

Watch Now!
Clinical Tip for Fixation of a Collagen Membrane

This video provides a clinical tip with regards to the fixation of a collagen membrane.[...]

Watch Now!