The premolar teeth often fracture when they have a root canal. This is because they have dip in the root really high up that we call a furcation and sometimes really steep cusps.
Implant Replacement Same Day
In my practice in Burbank, California, this particular upper tooth that lies behind the canine is most often done as an immediate implant.
So all on the same day I will:
Extract tooth
Place implant
Bone graft the void around the implant
Make an immediate temporary with good contour
The benefit of immediate implant in this area is it allows you to smile without having to wear something removable and most importantly prevents the collapse of gum and bone if this is done in stages. This prevents the formation of black triangles. Another option could be socket shield for the right cases where a piece of the root could purposely be left in.
Immediate Tooth Implant
I always make the implant temporary screw retained so that there is no excessive cement to harm the gum and bone graft.
On this case the final crown is monolithic zirconia and screw retained. Please note the shapely contours under the gum in order to maintain the bone levels over time.
The implant is also platform switched on purpose. This means that the implant is slightly larger than the abutment creating a step which can help the biology of the implant over time and prevent peri-implantitis (bone loss)
Ramsey A. Amin, D.D.S.
Diplomate of the American Board of Oral Implantology /Implant Dentistry
Fellow-American Academy of Implant Dentistry