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CHARLES LOGIUDICE
Poor emergence profile M & D of #19. What Mike
said on the mesial. On the distal, the mesial inter-
proximal of the #18 crown should have been re-contoured,
to create both a wider contact area, and some room for the
Sirona TiBase custom abutment.
SERGEI YURYK
I would guess occlusal overload. #19 emergence is
not great, M too bulky, D deficient, but the bone
loss looks similar on both sides. #20 restoration is close to the
bone as well with no issues radiographically.
GREGORY MARK
I was attending one of the lectures and lector
pointed out an area of resorption. If you look
closely, it reminds you of the socket shape and we’re
all talking about socket preservation and it was never
preserved.
KEN ALFORD
In addition to what I said earlier: thin tissue. It
is difficult to see the amount of attached gingiva
from photo.
MICHAEL MINGLE
Agree with what was said above. If this is an
occlusal overload situation, then the investment in
a tek-scan and a five-minute eval at time of placement would
have helped. The large smudges we see with articulating paper
tend not to be the issue. It is the small tiny dots that are hard to
see with articulating paper that create the greatest forces.
JEREMY BEWLEY
I agree with Gregory on his point. Read some
conflicting things recently re: allograft in humans
vs. rats, and does it ever really turn over into native bone in
humans. There’s a thought that allografts might act in a way
sometimes that leads to fixture failure. Interesting arguments
on both sides of that debate.
JEREMY BEWLEY
I’m guessing a smaller diameter fixture in the #19
position, splinted crowns, might’ve helped. What’s
opposing? Howwas the occlusion? Parafunction?Was there an
ignored prosthetic complication such as a loose screw? Is this
possibly an oral presentation of a systemic disease process?
OK, I’m spent. Looking forward to updates on this one.
DAMIAN CHUNG
Food impaction?
KEN ALFORD
Very nice graft. Contributing factors may have
been due to retained excess cement, poor occlu-
sion with heavy lateral forces, poor emergence/contours
of crown, irregular and open contacts or irregular gingival
embrasures causing food impaction?
DAVID EDELSON
Bad lab work?
DANIEL BUTTERMAN
My money is on occlusal overload/ parafunction.
Be curious to see the opposing.
ROSS ENFINGER
Obviously the failurewas due to the use of a Sirona
TiBase.
MIKE SKRAMSTAD (FACULTY)
Poor emergenceprofileon 19. ... Possibly impinging
too close to bone.
JUSTIN GATES
My guess would be a design/contour issue of the
restoration, a systemic issue, a smoker, parafunctional
habit or a combination ofmultiple issues, a.k.a. a perfect storm.
Feed our curiosity.
