Dr.Prashanthy R

CBCT / 3D X-rays can better depict bony defects , craters and furcation involvement , however periodontal ligament (PDL) space better scored on periapical X-rays.

This saving tooth attempt as patient wanted and it’s a success 🙌… Only Perio treatment was performed so far though perio +endo was the treatment plan . Patient has no sensitivity or pain after thd procedure .
In this case as clinical baseline examination showed a good attached gingiva and soft tissue coverage on tooth both labial and palatal side, never assumed the defect to be this large if there was no CBCT .
Clinically exudation and deep periodontal pocket 10 mm nd grade 2 mobility seen . Trauma from occlusion .
Assuming this defect as seen in CBCT might fit into Goldman & Cohen classification of osseous defects .
Flap reflection after a papilla preservation flap . revealed granulation tissue but not the extent of bone loss , since had a picture of CBCT image in mind , thorough degranulation was done until I could see the extent of defect nd even tiny spec of granulation tissue removed , bone graft and membrane placed , good primary closure achieved .

4 reasons to choose TISSUE LEVEL ( TL) implant in posterior region .kw
1. Minimal intervention around PERIIMPLANT tissue
2. Less susceptibility to Perimplant disease
3. Intrabony diameter of Tissue level Implant in narrower than bone level implant , thus minimizes the need for a bone grafting procedure
4. The built in emergence profile for the transmucosal part can achieve an optimal emergence profile for posterior restoration.