Zeramex Zirconia Impant Case on Tooth 13

very nice work. in my practice that is probably an endo and crown

Did you try to fill the tooth? Maybe it was not exposed. No periodical is posted.

I don't understand the reason for extraction on this tooth. It is possible a root canal did not have to be done. Even if it did, it looks to be restorable.

I'm a periodontist. I also think this looks nice, poss a bit deep, but I would yield to the judgement of the clinician there. Truly, i would have encouraged endo and a crown as well.

Why PRF and collagen? One or the other would be more than adequate. Ozone infusion and a non-metallic implant? Are you one of those dentists who doesn't "believe" in endodontic therapy? Is there a history of endodontic therapy failing on this patient? I am a frequent expert witness in malpractice trials and I'd have a tough time defending that extraction, especially without a periapical x-ray.

Since options were explained, it’s not a leaf all issue.

Not really the patient came this week with pain as emergency. The initial x-ray was from December 2017. The patient does not like over exposure of x-ray and I consider not necessary another one, only with percaution know what the tooth are in problem. All the options were explained to the patient and she said that she does not want the root canal treatment. If the nerve was exposure. She like to replace by metal free implant (zirconia dental implant) only. We are a holistic office and the patient too. Even we are holistic office we explain all options and if the patient want to keep the tooth with RCT, we do not do RCT in our office and refer the patient to Endodontic Specialist. The tooth #12 was repaired with DO composite filling, However, tooth #13 the decay was in the pulp chamber and for that reason was replaced by Zirconia dental implant.

Thumbs up on presentation. You would have had a better arguement had you left out the “holistic” approach. Dentistry is evidence and fact based. Holistic sounds very bs to me. I’m sure I’m not the only one who feels this way.

Nice case and kudos to providing the patient with options. In certain situations, I do wonder how many more patients would choose an implant over RCT, if they were given a full explanation of both procedures. https://www.ncbi.nlm.nih.gov/pubmed/29499242

I have placed implants for 25 years and done endodontics for 45 years. There is an undefined demarcation line wherein the best option is an implant. Any tooth with major decay or endodontic problems down the years can pose the patient with vexing complex expensive problems whereas a simple extraction and immediate placement with immediate loading has its merits in simplicity and financial comparison. An excellent restored tooth may be only one bite away from splitting whereas a successful implant has a simple future: failure can often be painless, and an oversized implant can be placed immediately. A good implant outcome will be less trouble than a tumultuous endodontic restorative election. Me? I would opt for an implant rather than the sequence of pus, extirpation, dressings, obturation, post and core, crown impressions then a pork gristle or toffee and all is lost. It is certainly the patient’s decision yet it behooves others to not judge the multi-factorial reasons why that decision was and remains valid.

I respect your point of view! I because had the same of you three year ago ! One of my best friend was intoxicated with Mercury, 400% more than a person live in Alaska and the diet is wild catch fish. He only removed Amalgams and replace by filling or crown without any protection. Sorry, with protection a mask with level 1 filtration. He lost gran portion of his hair and felt dissy all the time. He stop to work for a few months and the only work to reduce the high level of mecury was IV infusion of EDTA ( chelation therapy) . Yes!!!!!! the same we used. The ADA said !!!The mercury is safe in amalgams !!!!!!bbbbbbbssssss!!!! Now the Depart of Health require for 2020 All dental office in US with Amalgam separators and need to change every 10 years. Why???? Because the mercury level in the water is super high. Who sallow and take a shower with ???? you and me😝😝😝 I started to feel like my friend and I started losing hair. I started looking for information and learn from them. My recommendation if you like to take it! is protect yourself because when you are pushing flower inside a sarcophagus it will be too late. The RCT is another theme, I respect the endodontic specialist point to safe the tooth but I saw other point in the patient health. My friend open your eye!!!!then you will validate the word Holistic !

> excellent case presented and well done .Thanks for sharing.

Option implant should not have been mentioned to patient in this case at all unless you think that’s one of the good options. Would you have done this to your first family?

An interesting definition of holistic. Too much dentistry for what is a straightforward and trivial dental problem.

Does this patient know that the screws used to attach the abutments to the implants are made of Titanium? Lets get real. This whole "metal free" thing may sound appealing to the weak minded but is actually a complete farce. Zirconium oxide is a METAL.

The 'Wellness' movement will not be stopped. Americans are educating themselves and choosing products that are the least harmful. This is occurring in every daily decision from the foods people select, to the travel destinations, to their medical choices. Every dentist would be remiss to not incorporate and encourage some wellness concepts and treatments into their practice. Those who do not evolve with consumers’ changing demands will wake up one day realizing: 'This isn’t niche anymore . It’s eating into my share'

After having done dentistry for forty years, I always suggest treatment I think is in best interest of the patient. This case looked to me like a simple endo and ceramic crown. If after having explained all options the patient request removal and implant I can live with that. My experience is that not all implants are successful, they can fail but not at the rate of endo teeth. Complexity of the endo and restorability of remaining tooth structure have a big influence on what treatment I suggest. A well done implant vs a well done endo ,my money is on the implant in ten years, particularly if the endo is a molar. Great discussion here thanks to all contributors!

IMG_0043.HEIC

I am a 100% ceramic guy and have seen and try all teh systems out in the market, this is for sure a challenge of a case. I have had my doubts on the pastic screw and seen breakage BUT metal screws also break and both cause micro leakage. Thanks for sharing!

I think somebody here was thinking more about his daily production than patient's benefit. Please, be honest to yourself, doctor.

Seems to me u were just dying to place an implant.

BOTTOM LINE IS YOU DON'T PERFORM RCT'S IN YOUR OFFICE