The patient was in a bad bicycle accident, which left her severely injured. Her most notable injuries were the fracture of her front teeth. One tooth (a central) came out completely, while the other three anterior teeth were fractured off. It was determined that the other central (think: front middle tooth) would also have to be extracted as the tooth was fractured in the root. The other teeth, the laterals would need crowns to restore them, but, could be saved. So, we proceded to extract and bone socket preservation graft the sites for #8 and #9.
NOTE: If you are looking for the blurred out picture from the Instagram video, it can be found below in the gallery of images.
Extraction Site Immediately after grafting was completed 
Implant Placement into previously grafted sites 
Implants with computer designed custom lab-fabricated abutments 
Implants with custom abutments and lab-fabricated Zirconia Crowns
The bone graft was placed into the site of the missing teeth. In this case we used cortical bovine bone, covered with a collagen plug and sutured with 3-0 Chromic Gut, resorbable suture. These grafts typically take 4-months to turn into “your bone.” After your body discovers the graft bone, it determines that it should replace it with its own bone. This starts a two-tiered process of osteoclasts, which break down the grafted bone, followed immediately by osteoblasts, which replace the old bone with your own brand new bone.
Feel free to flip through the other images of the case in her gallery. Note: the bone graft photos that show the area immediately after extraction and grafting show a little blood, and the laterals were not yet restored with crowns. So, feel free to skip the fractured image if you have a delicate stomach for even a minimal amount of blood. The patient waited longer than the normal 4-months before implant placement. We elected to wait 7 months to let the bone solidify, since the facial plate was destroyed during the accident. After implant placement, we allowed the implants, plenty of time to heal, as they required careful and adequate healing. Today we finished the case and delivered the two computer designed custom-
titanium abutments with Zirconia crowns.
This was a challenging case due to bite and spacing considerations. But, we were able to give her back a fixed solution that allows her to floss these teeth separately. You will be pleased to know she is still an avid cyclist. Thanks,
Dr. Russell McFarlane
(below you will see the original censored Instagram version, then, the uncensored YouTube version of the photos immediately following)
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