A Broken Premolar, a Bone Graft, and a New Implant: A Kharghar Case Study

A tooth that snaps off at the gum line is more than a chipped-tooth problem — often the root left behind can't be saved, and whatever bone was holding it can be affected too. This is a real case from Reform Dental Clinic in Sector 15, Kharghar: a patient came in with a fractured upper right first premolar and a retained root underneath. Here's what it actually took to fix it, step by step, with the clinical photos from the procedure. (A heads-up: a few of the images below are from the surgery itself and show the treated site directly.)

The Problem: A Fractured Premolar and a Retained Root

The tooth had broken down at the gum line, leaving a root piece rather than something that could be saved with a filling or a crown. The photo below is from the first visit, showing the upper arch and the site that needed attention.

Step 1: Removing the Retained Root

Once a tooth has fractured down to the root like this, the piece left behind usually can't be restored — it has to come out before anything else can be planned. After the root was removed, the buccal bone (the outer wall of bone on the cheek side, which normally cushions and surrounds the root) was found to be thin and exposed. This is a common finding when a tooth has been fractured or infected for a while before it's treated, and it changes the plan: an implant can't simply go straight into a site like this, because there isn't enough surrounding bone yet to hold it securely for the long term.

Step 2: Rebuilding the Bone Before Placing the Implant

Because the buccal bone was thin, the site needed to be rebuilt before — and alongside — the implant, using a bone graft and a GBR (guided bone regeneration) membrane. The graft material gives the body a scaffold to rebuild bone around the implant, and the membrane holds it in place while that happens. This isn't an unusual extra step; it's a well-established part of implant planning whenever the bone around a site isn't fully intact, which we cover in more general terms in dental implant candidacy in Kharghar: bone grafts and sinus lifts explained. The site was then closed with sutures to heal.

Step 3: Healing, Checked on X-ray

Once the site had healed, follow-up X-rays — a close-up periapical view and a full panoramic (OPG) X-ray — were taken to confirm the implant's position and that it had settled in well. This is a standard check before moving on to the final restoration; it's how the position is confirmed rather than assumed.

Step 4: The Final Result at Four Months

The patient came back for review after four months of healing, and the final crown was placed on the implant. The photos below show the site before treatment began and after the final crown was fitted.

What This Case Shows

A fractured tooth with bone loss underneath isn't a dead end — a bone graft and GBR membrane are routine tools for rebuilding a site like this before, or alongside, implant placement. That said, every case is planned individually after an exam and scan, and healing time and results vary from person to person depending on how much bone needed to rebuild and how the individual heals. If you're curious how a standard implant (without bone loss) is planned and placed, dental implant procedure Kharghar: what actually happens walks through that. If you're comparing an implant against a bridge for a single missing tooth, single tooth implant vs bridge in Kharghar covers both sides.

If you have a broken tooth or a retained root and aren't sure what your options are, message Reform Dental Clinic on WhatsApp and Dr. Shipra Mandwar will assess it honestly, bone grafting included if it's needed. You'll find us at Shop No. 10, Tricity Eros, Behind D Mart, Sector 15, Kharghar, Panvel, Maharashtra 410210, open Monday to Saturday, 9:30am to 1:30pm and 4:30pm to 9:00pm.