SRP I

A 40-year-old man (smoker, 1ppd) is concerned about #31 mobility (Fig.1).  Gross debridement is finished in his 1st appointment, while impression is taken for guide in his 2nd one. SRP has been scheduled for lower right quadrant with #31 extraction and immediate implant (Fig.2).  The tooth #17 extraction will be postponed.  The extraction may lead to mobility of the tooth #18, although SRP for the other 3 quadrant will be scheduled 1 week post #31 surgery.  Smoke reduction is encouraged, but no effect.  When the crown is delivered at #31 one year later, the tooth #18 is loose (Fig.3) with lingual fistula.  Since bone loss is more severe lingual (L *), a 5x10 mm immediate implant will be placed buccal (Fig.4).  The tooth #17 will be kept as a distal stop for guide and extracted after #18 implant placement.

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Xin Wei, DDS, PhD, MS 1st edition 07/26/2019, last revision 07/21/2020