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Fig 4: Pretreatment images; Patient returned after six years Fig 5: Pink tooth - patient came back after 6 years
complaining of mobile 21 and discoloration

Fig 6: Internal Resorption Fig 7: After 8 months achieving proper alignment of teeth

Fig 8: Crown extracted roots fragments to be curettage and Fig 9: Sequential IOPA of extraction of 21 and simultaneously
cleaned implant placement

4. Permanent prosthesis after alignment completion. in between for his orthodontic treatment. After four months brackets
MBT 022 slot brackets were fixed starting with alignment phase were removed and temporary prosthesis was removed to evaluate the
followed by gaining optimal space for the prosthesis to be given for gingival architecture (Figure 13). Healthy gingival architecture around
upper left central incisor. Optimal space was gained within the time the implant made us plan for duplication of same emergence profile
period of Eight months (Figure 7). After achieving proper occlusion, for the final crown. Temporary crown with temporary abutment was
overjet and overbite next plan was to extract the upper left central screwed to implant analog and immersed into a container with silicone
incisor and immediate placement of implant and loading with putty till cervical portion of crown. Once set, the temporary crown was
temporary prosthesis to preserve soft tissue structure and for esthetic unscrewed and impression post was attached to the implant analog in
purpose. 21 was extracted and resorbed root fragments were curettage putty index (Figures 14 and 15). 11
and cleaned from the socket followed by preparing the osteotomy site Remaining left out space in putty index (gingival collar) was filled
and immediate implant placement was done (Figures 8-10). Crown with flowable composite and cured. Now, impression post was screwed
portion of the extracted tooth was used to make the temporary inside the patients mouth to make an implant level impression with
prosthesis (Figure 11). putty and light body (Figure 16). 12,13 Final prosthesis was made
Tooth was trimmed till CEJ and luted onto temporary abutment in laboratory with customized soft tissue profile. Screw retained
with help of flowable composite. Grafting was done buccally with prosthesis was torqued into the patient’s mouth on completion and
alloplast bone graft and CTG. Screw retained temporary abutment was IOPA was taken (Figures 17-22). Periodic follow-up was done to
screwed and IOPA was taken to confirm the insertion (Figure 12). evaluate the outcome.
9,10
Follow-up was done after one week. Patient was periodically recalled
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