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Guided Placement of ZERAMEX XT using 3Shape after removal of infected root canal tooth

Written by Dr. Luis A. Alicea


Posted on May 14 2019

Case Report by Dr. Luis A. Alicea | April 21, 2019

Social Media Case Report posted on Facebook by Dr. Luis Alicea - Your Desired Smile
Title: Guided Placement of ZERAMEX XT using 3Shape after removal of infected root canal tooth.

Patient had a defect in porcelain fused to metal (PFM) bridge restoration 11 (23) to 13 (25) and wanted individual teeth again due to difficulty keeping the area clean. Also, patient experienced pain on tooth #14 (26) due to reinfection of failing root canal. Pain and infection persisting for restore for more than 1 year.

The Endodontist Specialist recommend root canal re-treatment. The patient does not want re-treatment. The patient consented for zirconia implant to be placed at #12 (24), and extraction of tooth #14 (26) with bone graft for future implant restoration. The digital treatment evaluation was conducted with Scanora 3DX CBCT, Trios 3 Intraoral scan and the ZERAMEX files in 3Shape Implant studio. Formlabs 2 3D printer was employed for printing of a surgical guide.

PFM bridge, amalgam build up and decay (cavity) were removed with SMART (IAOMT) protocol. Decontamination of the teeth with chlorhexidine and ozone. Build up was done with composite build up material and re-prep for crown and bridge restoration. Surgical guide was used to place an all ceramic ZERAMEX XT RP (zirconia implant). To improve the healing process Protein Rich Fibrin (PRF) and primary closure chromic gut sutures were used on area of #12.

The provisional (temporary) bridge was made with Luxatemp for healing purpose. Surgical extraction of tooth #14 (26) was done. The surgical area was decontaminated with surgical curettes, burs, chlorhexidine, normal saline 0.9% & ozone. Surgical Piezo instrument was used for sinus elevation. Sinus and socket graft were done with PRF, B-TCP bone graft Augma Biomaterials USA Inc., Collaplug by Zimmer Biomet & nylon sutures. The case was conducted under IV Sedation by Dr. Luis A Alicea at Your Desired Smile, Tampa, Florida


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Dr. Luis A. Alicea 
was born and raised in San Juan, Puerto Rico. He pursued studies at the University of Puerto Rico, School of Dentistry. He then completed his Masters Degree, and Prosthodontic residency at that campus, where he focused his training in the placement, and restoration of Dental Implants. He has taught as an Associate Professor in the Research, and Restorative Departments at the University of Puerto Rico, and continues to hold privileges as a professor Ad Honorem in that institution. Dr. Alicea also completed additional training towards certification as an IV Sedation provider, at the University of Alabama, Birmingham.

Dr. Alicea is a member of the Peer Review Committee for “The International Journal of Oral & Maxillofacial Implants”, and regularly reviews articles prior to publication for this Journal. He is a also member of the American Dental Association, American Academy of Cosmetic Dentistry, American College of Prosthodontics, Florida Prosthodontic Association, American Academy of Implant Dentistry, Academy of Osseointegration, American Dental Society of Anesthesiology, West Coast District Dental Association, Hillsborough County Dental Association, and also participates in the Seattle Study Club.

Dr. Alicea has an undeniable passion, and dedication for the dental profession. He has been practicing in the Greater Tampa bay area since 2007. He likes to give back to the community and participates of Dentistry from the Heart events. He loves spending time with his wife, daughter and twin sons.



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