Saving tooth #3 in lieu of sinus graft and implants

Pre-operative diagnosis

1.  #3 clinically open crown margin with recurrent caries

2.  #5 clinically open crown margin with recurrent caries

3.  #3 Recession and minimal attached tissue

4.  #3 Grade 1 furcation involvement

Initial deconstruction

Core buildups for surgical correction

Notice core extends to the periphery of tooth

#3 core is in furcation. Without biologic shaping this tooth has non- restorable prognosis

Surgical provisional intentionally left shy of the tissue to allow soft tissue grafting

Surgical correction of furcation, margins and soft tissue.

Final impressions

Delivery- 2008.  #3-5 PFM FPD with porcelain margins

13 YEARS POST OP

Before

After

SUBTLE & AMAZING POINTS

1. Complied with patient desire to save tooth and avoid implants

2.  Actually increased prognosis on Miller Scale from:

15 year 95 % survival and 30 year 85% survival to a

15 year 97 % survival and 30 year 93% survival 

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