The patient is a 60-year-old, nonsmoking male presented with pain at tooth #5 (14) caused by a dental abscess. Clinical and radiographic examinations, including panoramic imaging and CBCT, revealed that the abscess had destroyed the buccal cortical bone plate, although the tooth remained clinically stable. The maxillary sinus retained its anatomical integrity, but imaging showed an inflammatory reaction in the Schneiderian membrane.
The defect involved the buccal cortical plate and required careful management to prevent horizontal and vertical bone resorption or collapse. Therefore, the clinician planned immediate grafting of the extraction socket at the time of tooth removal. Because the site was infected, barrier membranes were contraindicated. The clinician instead selected a grafting material suitable for infected sites that could promote bone regeneration and reconstruct the buccal cortical plate.
Considering these factors, the clinician extracted the tooth and immediately grafted the socket with biphasic calcium sulfate (Augma Bond Apatite®). The treatment plan delayed implant placement for several months to allow new bone formation and reconstruction of the buccal cortical plate. The extent of bone destruction caused by the cystic lesion prevented reliable primary stability, making immediate implant placement unsuitable.
