Extraction and Immediate Bonded Bridge

A photo essay

Patient F presented to the office for her 6-month Re-care appointment, when it was noticed that # 24 had a facially draining abscess. Radiograph below shows mandibular anterior teeth with extensive bone loss with periapical lesion on # 24.

Treatment option discussed included coronal splinting with or without RCT. Given the advanced state of bone loss of the adjacent teeth and their guarded long term prognosis it was decided to not involve them in any long term restorative plans. Given the size of the periapical lesion and the drainage into the oral cavity, the prognosis of success with RCT was extremely guarded. Patient agreed to extraction and immediate re attachment of the extracted tooth by extra coronal splinting to the neighboring teeth. Patient is aware that sometime in the future she may lose the front teeth at which time the treatment options will need to be revisited.

Model used to demarcate the region for placement of Extra coronal splint.

Essix style template made and section of the splint was cutout.

Ribbond® splint sectioned and adapted to the template with cutout

Template try in to confirm fit

Extracted tooth sectioned at the root tip

Extracted tooth replaced in the template and had the Ribbond® Splint attached to it by bonded composite. (For detailed instruction on use of the splint material please visit the manufacturer’s online site.)

Tooth reattached to the neighboring teeth with bonded composite.

Tooth after seating appears below Occlusal table. In this position, there is minimal Occlusal stress on the tooth and might assist in uncomplicated healing.

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