Posted at 16:52h
Mrs R was referred to the surgery after successful periodontal treatment completed at a teaching hospital. She was a regular attendee to the hygienist and her oral hygiene was immaculate. She had already been told that the anterior teeth may need extracting in the future and was referred for advice on the now mobile upper right lateral incisor and the upper left central incisor.
Mrs R was also upset with the two adjacent teeth, with their colour, shape and size. The loose teeth had poor bone support and while we may have been able to improve their appearance with orthodontics and new restorations it was decided that the best long term treatment was extraction and replacement with dental implants. We also decided to restore the adjacent teeth to help with harmony, aesthetics and function.
The teeth to be extracted had extensive bone loss and while bone grafting may have been ideal, finances and patient’s desires precluded this option. The bone support on the adjacent teeth was good. The attached gingival, the bone support beyond the root apices also good, hence i felt an immediate approach may help to support the gingival levels. I advised the patient that this may not be ideal – she was happy with option and accepted all the risks and benefits.
Hence we completed immediate implant placement with delayed loading – adapted sulcus formers helped support the soft tissues. After four months the implants were loaded with Zirconium abutments and after temporisation for six weeks the anterior four teeth were restored with E-max restorations. The patient was ecstatic with the appearance. The treatment was completed in 10 months, the costs were £5 545. The patient left a 25% deposit and completed a 24 interest free program for the balance....