Cracked tooth extraction, immediate placement of three implants with gum surgery

Patient Anna
Date 10.2023

Initial situation


Patient Anna came to our clinic with complaints of periodic pain in the posterior tooth on the left lower jaw, as well as the long-term absence of two chewing teeth on the same side, which is why the patient was forced to chew food only on the right side for several years.

Contour Before

In the oral cavity, we observe the absence of two left lower molars (teeth 3.6, 3.7), in the area of ​​which a decrease in the gum contour can be seen due to their long-term absence (marked by an arrow), and the second premolar (tooth 3.5), in which the patient complained of pain, restored with a metal-ceramic crown. Visually, the tooth did not look “problematic”.

Periapical X-Ray – Before

And even on a periapical X-Ray, which shows that the tooth has been restored with a large metal post, no pathologies are visualized.

CBCT – Before

Only a computer tomography shows that there is a focus of inflammation (circled in red) on the side of the tooth, indicating a fracture of a very thin root wall. This happens quite often when a tooth is restored with such a large post.

Unfortunately, a tooth root fracture is a direct indication for tooth extraction.

We suggested Anna to remove the tooth and immediately replace it with dental implant simultaneously with implants placement in the area of ​​the missing teeth, and perform soft tussue transplantation, thus performing all the surgical stages in one procedure.

Progress of the treatment


Under local anesthesia, a cracked tooth 3.5 was carefully extracted, an implant was placed in the socket of the extracted tooth in the correct position, two dental implants were placed next to it in the area of missing teeth, healing abutments were immediately fixed and a gum transplantation was performed to compensate the loss of its contour.

X-ray after surgery

Control X-rays were taken, on which we can see the correct position of the implants.


– Antibiotic prophylaxis 7 days

– Painkillers for postoperative comfort

– Oral rinses with an antiseptic solution 4 times a day for 7 days

– Ice application for 15 minutes for the next few hours

– Refrain from hot food and drinks, physical activity, and being in the heat for several days

– Do not chew food on the left side for the period of implants integration (1.5 months)

After 2 weeks

After 2 weeks, the patient came for an examination, during which we saw that the implants site was healing favorably, and we took a break for 2 months to allow the implants to integrate.

After 2 months

After 2 months, the patient came for implant crowns. In the oral cavity, you can see how the gums have thickened in the area of ​​missing teeth.

After healing abutments removal, we observe mature gums in the area of ​​​​successfully integrated implants, so prosthodontist dentist Eduard took impressions to send them to a dental laboratory for the implant crowns fabrication.


After 4 days, the zirconium implant crowns were ready, the patient was invited to the clinic, and prosthodontist fixed the crowns onto the implants.

X-ray after

We took control x-rays after fixing the crowns.

And the patient, satisfied with the shape and color of the crowns, left the clinic with new teeth, which provided her with the ability to chew well on her left side.

In the before-after photos you can clearly see how in 3 months we completely restored the chewing function on the left side, as well as got a good gums volume in the area of ​​the implant crowns, which will ensure a long-term and stable result and prevent food from getting stuck in this area.

Duration of the operation – 2 hours

The total cost of extraction, implantation and prosthetics of three teeth is 26,450 AED

Doctors who treated

Dr. Aleksandr Siniakov
specialist Oral Surgery, implantologist, periodontist;
languages: English, Russian
Dr. Eduard Ziganshin
general dentist, prosthodontist;
languages: English, Russian
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