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
