The patient is a 60-year-old healthy woman who complains of pain and bleeding in the area of tooth #35 (20). The oral examination reveals bleeding and a high degree of inflammation on the buccal side of teeth #35 (20) and #36 (19), with a lack of keratinized tissue around tooth #36 (19). A bridge is present and exhibits lateral movement. Complementary examinations show an old bridge connecting a natural tooth #35 (20) to an implant #36 (19), associated with a large cyst and loss of the buccal bone wall at the premolar site, as well as lack of osseointegration of the implant. The patient does not wish to lose the teeth.
The treatment plan includes extraction of both teeth, removal of the granulation tissue, and performing bone grafting using bone cement. After six months, two implants were placed, along with an additional bone graft for lateral augmentation. Four months later, the clinician exposed the implants and placed bone cement to augment both bone and soft tissue. Two weeks later, the clinician placed the definitive crowns.
