Difficult case I need advice on
Hello everyone. I am Dr Adam Kimowitz. I have a small practice and NJ and I have met some of you though the GRP. I have a cat here where I am restoring 7-10 with porcelain/ zirconia crowns and I am having problems with the perio. Specifically the papilla between 9 and 10. We 9 is an implant and 7,8,10 are natural.
The problem is some (a lot) of the bone was lost during the extraction and implant placement and it appears like it cannot be removed.
It is a significant defect. class 3 with about 4 mm of papillae loss. I am not sure whether or not to suggest free gingival graft or more specifically a pin hole technique connective tissue graft. I know a lot of you on her are more of research oriented so I would like you opinion on how to fix.
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