PERIODONTICS: The Little Things That Count

by Peter Birek, DDS, MSc, Dip Perio

A highly cosmetic replacement of a maxillary anterior tooth with an implant-supported crown is, at most times, a challenge. Since the immediate insertion of an implant into a “clean” extraction socket is often not feasible or desirable, the prosthetic-surgical team is faced with difficult hurdles. In combining the experience of several cases I plan to illustrate below, in sequence, the little tricks that can make a difference and lead to outstanding results. In the left column I will illustrate the “good moves”; in the right column you can see the equivalent stage which did not work very well–the “not so good moves”. Short comments between the pictures, in the middle column, highlight the issues illustrated by the pictures. Ridge preservation utilizing varied bone grafting materials is a subject in its own and hence I did not deal with it in this brief illustration.