A healthy 65 year-old male presented to the surgery with the chief complaint of a loose front tooth which was uncomfortable upon chewing and pressure. A radiograph revealed significant bone loss around tooth 22 in addition to the focalised loss of internal tooth structure in the mid-third of the root. The root was almost perforated.

Clinical examination revealed a lack of recession with a Class III mobility. No drainage point or fistula were noted.


A diagnosis of internal resorption was given due to the focal point of radiolucency within the pulp chamber area. The ultimate fate of the tooth did not change. Due to the extent of the defect and the advanced bone loss, it was recommended that that tooth be removed and other restorative options be assessed.

Two days later, the patient called the practice to advise that the tooth crown had completely severed. An immediate flexible partial denture was fabricated for aesthetics and surgical removal of the tooth was planned with the oral surgeon.

The implant was placed and a screw-retained restoration was planned. The implant was submerged during the healing phase and the removable partial denture was adjusted. An appointment was scheduled for 3 months later to expose the implant and the periodontist placed a 5mm healing abutment. For more details, download the Case study from the link above.