Our young patient came to our office complaining about a very red and painful gum next to her right central incisor. After we had a CT scan, we noticed that the tooth had a root resorbtion and needed to be extracted. Both central incisors had old root canal treatments and, because they were discolored, she had repeated internal tooth whitening.
Internal whitening is a very good solution for non-vital discolored teeth, but done incorrectly or repeated too many times, was reported to cause root resorbtion. In this particular case, there is a very righ esthetic risk, because the patient has a high smile line, showing all her gums.
This is why we decided to have orthodontic extrusion, to get the best bone volume and the best tissue possible at the moment of extraction. We had an imediate implantation using a Megagen Anyridge implant and a temporary crown to mantain and shape the gum identical to the other central incisor. In the end, the final crown is a ceramic and zirconium screwed crown, plus a ceramic veneer for the left incisor, to help mentain a stable color for this tooth too.