A 27-year-old female patient was missing tooth #46 and desired a replacement to improve chewing. Upon removing the retained root stump, the surgeon discovered a broken instrument tip in the extraction socket between the root and bone. Both the root tip and broken instrument were successfully removed. An implant was then placed in the desired position in the same appointment and bone grafting was performed to complete the procedure.

2. • Case characteristic
 Tooth no. 46 with retained root stump in
a healed extraction socket was to be
removed using atraumatic procedure

3. • Case characteristic
 Broken instrument tip
noticed during
osteotomy in between
the retained root stump
and alveolar bone

4. • Case characteristic
 Implant
placement
during the same
appointment in
the desired
position

5. • Introduction
 A 27 year old healthy
and jovial female with
no significant medical
history reported with
the desire to replace
missing tooth in tooth
no. 46 region for the
purpose of chewing

6. • Introduction
• Interocclussal distance
– 15 mm
• Mesio-distally
 – 8.2 mm
• Buco-lingually
 – 6.5 mm

7. • Radiograph

8. • Radiograph

9. • Treatment planning

10. • Treatment planning

11. • Incision and reflection

12. • Osteotomy

13. • Complication

14. • Removal of Root tip and broken
instrument tip

15. • Root stump extracted

16. • Implant placement

17. • Bone graft and sutures placed

18. • Final Implant position

19. Thank you