A 21 year old young medical student from Chennai rushed to our Dental Hospital with lacerated gum tissue and uprooted upper left front tooth. Patient reported to have had an accidental fall at her house a couple of hours back. The traumatized area was profusely bleeding, also the patient was in immense pain. The pain was so awful that the patient requested on an immediate solution to bring her out of the agony.
On clinical examination, there was a significant amount of swelling on the patient’s upper lip. The upper left front tooth had been displaced and mobilized. Also the gum tissue surrounding the relative site had been teared from the traumatic fall.
OPG (full mouth x-ray) taken revealed horizontal root fracture of the upper left front tooth. No pathological findings seen on the surrounding tooth structure. No signs of bone fracture.
Treatment option of stabilizing the fractured tooth with a rigid wire followed by observation of the tooth for 3 to 4 weeks was explained to the patient. As the patient was young and conscious esthetically, she demanded immediate correction of the fractured teeth. She requested for a permanent solution as she was planning to attend an upcoming event in a couple of months.
Considering the patient’s age and need, renounced maxillofacial surgeon and Implantologist, Dr. SM Balaji decided to extract the fractured tooth followed by immediate dental implant placement under local anesthesia. The patients age and adequate bone level was ideal for a dental implant as the bone tends to repair rapidly when compared to a much older patient. A thorough blood investigation revealed no underlying abnormalities. The treatment plan was explained and patient’s consent was obtained.
Under local anesthesia, Dr. SM Balaji extracted the fractured upper left front tooth. The lacerated gum tissues were raised. Dental implant of adequate height was carefully placed with precision. The gum tissues were cleaned with saline and closure was achieved with dissolvable suture. Post operative OPG shows well positioned implant at the relative site.
The patient was under antibiotics and painkiller for 3 days to cope up with the moderate swelling and discomfort. Patient had to wait for a healing period of 3 months for the bone to osseointegrate with the implant. Meanwhile a removable prosthesis was given to the patient as it would look aesthetically unpleasant without upper front teeth.
Eventually after a duration of 3 months, a fixed ceramic prosthesis was placed over the implant. The ceramic prosthesis blended well with the adjacent teeth giving her a natural alluring look. The patient was extremely happy with the outcome . She walked out with a ravishing smile. Patient had been on regular follow up over a period of 3 years