The patient returns to US a year and half later for the completion of the case granted the conditions are suitable for restoration. Below are the lab fabricated abutments that will fit the implants in the mouth.
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1)

Below you will see the upper portion of the tooth (coronal aspect or clinical crown) sectioned and removed. This is done to facilitate the removal of the rest of the roots prior to implant surgery. The patient wanted the implant surgery done the day of the extraction of the teeth and would not be able to do a 2 stage treatment due to living outside the US. My concern was the amount of infection and lack of good bone. The treatment was made much more challenging due to limited mouth opening and restlessness. 2)
Pictures 3 and 4 show the sectioned root and extracted tooth. Notice the pink is the filling material that had inadvertently perforated through the root and one major cause of failure and bone loss. 3)
4)
Pictures 5 and 6 depict the implants immersed in bone. The positioning is not ideal. There was not enough bone so I decided to engage the only available bone which was any lateral wall with bone. At the same time bone graft material was also placed to ensure a better outcome. Finally sutures were placed and patient was dismissed. Patient reported no post operative pain at all and left the state 2 days later for overseas. 5)
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