Patient involved in a road traffic accident in his hometown

The patient is a 24-year-old steel worker from Bokaro steel city in Jharkand, India. He was riding to work on his motorcycle around two years ago when he was involved in a road traffic accident. The patient was an unhelmeted rider at the time of the accident. Impact from the accident had led to avulsion of his upper central incisors as well as right lateral incisor.

He had been taken to a nearby local hospital where first aid had been provided and wounds cleaned and debrided with antiseptic solution. Bone growth has been completed in the patient as he is 24 years old. There were no broken bones from the accident.

A visit to a local dental clinic, a month later had resulted in the patient obtaining removable dentures for the missing teeth. He had found them to be esthetically acceptable, but functionally inadequate. Prolonged use of the removable dentures had led to bone loss at the site of the avulsion.

Decision to undergo rehabilitation with dental implants

A friend had recommended that he undergo dental implant surgery for permanent rehabilitation of his missing teeth. He had visited a nearby dentist who examined him. Realizing that the patient would need bone grafting for dental implants, he had referred the patient to our hospital.

Our hospital is renowned for dental implant surgery in India. All-on-4 implants, zygoma implants and single implants are all available at our hospital. We also have an in house dental laboratory for fabrication of quality ceramic crowns, porcelain crowns or zirconia crowns or bridges.

Monolithic zirconia bridges are a specialty at our hospital. Bone graft surgery for dental implant placement is a common case which is done here. There are scores of patients being rehabilitated at our hospital.

Patient presents at our hospital for rehabilitation of his missing teeth

Dr SM Balaji, dental implant surgeon, examined the patient and ordered imaging studies. Imaging studies revealed that the patient lacked adequate bony support for placement of implants. After conducting various studies, it was decided to harvest bone from the region of the lower molar teeth to be used as a graft.

It was explained that this would help consolidate bone in the region of the missing anterior teeth. The harvesting process was also explained in detail to the patient. He expressed understanding of the treatment plan and consented to dental implant surgery. The best bone graft material is always autologous bone graft.

Successful placement of dental implant and bone graft

Under general anesthesia, a bone graft was first harvested from the mandibular third molar region. This was followed by placement of two Nobel Biocare dental implants in the patient’s anterior maxilla. This was followed by shaping and placement of the grafts in the region of bone deficiency. The bone graft pieces were fixed in placed using titanium screws. This was followed by suturing of the flaps.

Postoperative instructions to the patient

The patient was instructed to present back at the hospital in three months for fabrication of crowns. This period would enable complete osseointegration of the dental implants with the surrounding bones and consolidation of the grafts. The patient expressed understanding of the instructions and thanked the surgical team.

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