Case #11 By Friedrich Sauer

Written on 12/09/2017
Masoud Abu Zant

Intentional Replantation or surgical extrusion

#RIPECase55

#endo #direct #replantation #intentionalreplantation

I was looking forward to share this case I recently did.


The central incisor fractured pretty bad and most of you would have done a implant.
Maybe even an implant with PET as I just saw from Howie Gluckman at the online esthetic master (great lecture)

I used surgical extrusion for gaining ferrule. The tooth was a traumatically extracted with something called Zalex.

First I isolated the Case, retreated it and placed a post. The post is probably not necessary but at a lecture about this intentional replantation a post was suggested.
As a temp and for better splinting I did a build up with a silicone key.
The extrusion was done in a separate appointment and I splinted for 15 days. The mobility of this tooth was the same as the neighboring teeth.

So far I have done around five of this kind of treatment in this year. Follow ups are needed of course.

Greetings from Berlin 

ps:

There is no post op extrusion picture ... I’m awfully sorry and I hope the post op xray gods will forgive me

 



Initial - high mobility

 



The fracture

 



Before isolation

 



Well ...

 




Removing of the old cement

 



More sandblasting

 



And sealing of the dentin before NaOCl - this is a geeky thing calles IES, instead of IDS

 



Some xray

 



Fiber post - probably overtreatment here

 



The palatal shell

 



Last xray before extrusion

 



Apparantly i suck in composite

 



Just cutting the fibers before extrusion

 



Sandblasting

 



Extruded

 



About 3mm extrusion

 



Some kind of shaping

 



Well too much shaping

 



15 days of splinting later

 



Time to remomve the splints

 

 



Polished

 



Some proof of 3mm

 



Done By Doctor : Friedrich Sauer