Case Report: GTR Ensures "Harmless" For Adjacent Tooth Implantation

Periodontitis is the leading cause of tooth loss in adults. It is recommended to carry out targeted treatment based on the prognosis of adjacent teeth, and complete periodontal surgery on adjacent teeth before or at the same time as implant surgery to make adjacent teeth "harmless". The patient wanted to have dental implant due to the absence of upper right second premolar for 10 years. There were obvious gingival recession at adjacent teeth. The proximal probing depth of the upper right first molar was 10mm. CBCT showed the proximal vertical bone lose of tooth #16 was to the apex of the root, which spread to the future implant site. During surgery, the bone defect of tooth #16 was 7mm deep and 5mm wide, and involved the whole proximal surface of the tooth, also involved proximal root furcation. After thorough debridement, bone grafting and GTR were made. 6 months later, the local probing depth was only 2mm without bleeding. CBCT showed the proximal bone defect was well filled. During the implant surgery, GBR was made for further improvement of local soft and hard tissue morphology. Severe bone defect and furcation involvement of adjacent teeth should be treated before implantation. Good GTR could lay a solid foundation for the preservation of natural teeth, and provide a possibility for good prognosis and long-term stability of adjacent tooth implantation. Dentists should keep up to date with their treatment concepts and professional skills. For patients, the desire not to have tooth extraction is respected.