Replacement of compromised teeth and space closure with dental implants

This is a case of a 52 year old female patient with a complaint of mobile lower front teeth. The patient stated that she’s been experiencing severe mobility of her lower front teeth for a while as a result of which one of her lower anterior had fallen out recently. Since then, the gaps between her lower front teeth have started to get wider and the persistent mobility of her teeth often gave her tough time pronouncing certain words. The unpleasant look of her lower teeth worried her. She requested for a solution to bridge the gap between her teeth in order to restore the normalcy of her oral function and appearance. Patient gives a medical history of hypothyroidism, diabetes for the past 10years and is known to be on medication.

On clinical examination, the lower anteriors exhibited severe mobility with missing right central incisor.

On radiological examination, OPG taken shows generalized bone loss and surrounding tissue attachment loss in all the teeth.

Blood investigation revealed thyroid level under control with the blood glucose level slightly above the normal range.

With the patients demand in consideration, Dr.S.M.Balaji planned to extract the mobile anteriors followed by fixation of Dental implants under local anesthesia. A course of periodontal therapy (gum treatment) was also intended, as the supporting gum tissues were weak due to underlying periodontal pathology. The surgical procedure was briefed and patients consent was obtained.

Under local anesthesia, the mobile lower anteriors were extracted, followed by elevation of the surrounding gum tissues to expose the underlying jaw bone. Secondly, dental implants of appropriate size were fixed in the bone with utmost stability and precision. Finally, the gum tissues were approximated covering the dental implants with absorbable suture.

A course of antibiotics and painkillers were given for 3 days to cope up with the mild postoperative discomfort. Patient was educated on the postoperative home oral regime. She was asked to report after 3 months for the final prosthesis, to let the dental implants completely osseointegrate with the jaw bone. For the time being, a removable prosthesis was given to the patient to replace her missing teeth.

Post-operative OPG taken after 3months shows well integrated dental implants with the surrounding bone. Hence the final impression was taken, followed by few trials of bite alterations of the final prosthesis. A natural looking ceramic bridge was fixed onto the dental implants covering the unpleasant gap which was worrying the patient. There was an immediate improvement in the patient’s speech and she was more than happy with the outcome.