Replacement of broken root canal treated tooth with Dental Implant
[vc_section content_layout=”full” animation_delay=”” disable=”” id=”” class=”” bg_type=”image” bg_image=”” color_overlay=”” enable_parallax=”” enable_pattern=””][vc_row content_layout=”boxed” equal_height=”” animation_delay=”” disable=”” id=”” class=”” bg_type=”image” bg_image=”” color_overlay=”” enable_parallax=”” enable_pattern=””][vc_column layout=”normal” vertical_align=”top” animation_delay=””][vc_column_text]This is a case of a 36year old male with a complaint of broken crown in the upper front tooth region. He stated that his kid accidently hit him on his face the day before, which dislodged the crown in his upper anterior tooth right away. He gives a history of root canal treatment been done to the involved tooth 2years back elsewhere due to decay and discolouration. Now that the broken crown had come out, he felt less confident to speak or smile. He desired to restore the involved tooth with a new crown at the earliest. Patient had no medical history.[/vc_column_text][vu_heading style=”2″ heading=”EXAMINATION OF THE PATIENT” subheading=”” alignment=”left” custom_colors=”” class=””][vc_column_text]On clinical examination, the upper front tooth seemed to be extensively broken with only the root portion of the teeth remaining. No pain in the involved tooth. No laceration seen in the surrounding gum tissue. No extra oral injury seen. On radiological examination, OPG taken shows remaining root portion of the broken root canal treated tooth. No pathological findings seen in the surrounding bone.[/vc_column_text][vu_heading style=”2″ heading=”TREATMENT PLAN” subheading=”” alignment=”left” custom_colors=”” class=””][vc_column_text]On examination, the upper anterior had insufficient tooth structure to support and retain a dental crown, hence Implantologist, Dr.SM Balaji suggested to extract the broken teeth followed by dental implant placement under local anesthesia. Later, replacement of the crown portion of tooth with a fixed prosthesis. Alternatively, treatment of dental bridge placement using the support of the adjacent teeth was also suggested. Finally, he opted for dental implants, understanding that it was the best treatment plan for him. Patient’s consent was obtained.[/vc_column_text][vu_heading style=”2″ heading=”FLAPLESS DENTAL IMPLANT PLACEMENT” subheading=”” alignment=”left” custom_colors=”” class=””][vc_column_text]Under local anesthesia, Dr.SM Balaji extracted the broken upper front tooth. Secondly, dental implant of appropriate height was fixed directly into the empty tooth socket without reflecting the gum tissues. Followed by this, a lightweight temporary prosthesis was fixed onto the dental implant to replace his missing tooth for the time being.[/vc_column_text][vu_heading style=”2″ heading=”POST TREATMENT FOLLOW-UP” subheading=”” alignment=”left” custom_colors=”” class=””][vc_column_text]Post surgical oral care instructions given. The patient was asked to report after 3 months for the final prosthesis placement, in order to let the dental implant completely integrate with the jaw bone.[/vc_column_text][vu_heading style=”2″ heading=”THE FINAL PROSTHESIS” subheading=”” alignment=”left” custom_colors=”” class=””][vc_column_text]He reported back after 6 months for the final prosthesis. Post operative OPG taken shows osseointegrated dental implant with no pathological findings. Hence final measurement was taken to fabricate the fixed prosthesis accordingly. A natural looking Zirconia prosthesis was fixed onto the dental implant. The prosthesis was a perfect match to his natural teeth. The patient was very happy with the treatment outcome.[/vc_column_text][/vc_column][/vc_row][vc_row content_layout=”boxed” equal_height=”” animation_delay=”” disable=”” id=”” class=”” bg_type=”image” bg_image=”” color_overlay=”” enable_parallax=”” enable_pattern=””][vc_column layout=”normal” vertical_align=”top” animation_delay=”” width=”1/3″][vc_single_image image=”6038″ img_size=”full” add_caption=”yes”][/vc_column][vc_column layout=”normal” vertical_align=”top” animation_delay=”” width=”1/3″][vc_single_image image=”6039″ img_size=”full” add_caption=”yes”][/vc_column][vc_column layout=”normal” vertical_align=”top” animation_delay=”” width=”1/3″][vc_single_image image=”6040″ img_size=”full” add_caption=”yes”][/vc_column][/vc_row][vc_row content_layout=”boxed” equal_height=”” animation_delay=”” disable=”” id=”” class=”” bg_type=”image” bg_image=”” color_overlay=”” enable_parallax=”” enable_pattern=””][vc_column layout=”normal” vertical_align=”top” animation_delay=”” width=”1/3″][vc_single_image image=”6041″ img_size=”full” add_caption=”yes”][/vc_column][vc_column layout=”normal” vertical_align=”top” animation_delay=”” width=”1/3″][vc_single_image image=”6042″ img_size=”full” add_caption=”yes”][/vc_column][vc_column layout=”normal” vertical_align=”top” animation_delay=”” width=”1/3″][/vc_column][/vc_row][/vc_section]
Dental Implants for Malaligned Mobile Teeth
[vc_section content_layout=”full” animation_delay=”” disable=”” id=”” class=”” bg_type=”image” bg_image=”” color_overlay=”” enable_parallax=”” enable_pattern=””][vc_row content_layout=”boxed” equal_height=”” animation_delay=”” disable=”” id=”” class=”” bg_type=”image” bg_image=”” color_overlay=”” enable_parallax=”” enable_pattern=””][vc_column layout=”normal” vertical_align=”top” animation_delay=””][vu_heading style=”2″ heading=”CASE REPORT” subheading=”” alignment=”left” custom_colors=”” class=””][vc_column_text]This is a case of a 32 year old female patient, who approached our dental hospital with a complaint of mobile lower front teeth. The patient stated that her lower anteriors started to shake a year back, which over time led to severe mobility. She was also concerned with the malalignment of her lower anteriors. As a result of mobility and crooked teeth, patient felt difficulty to bite food as it caused mild pain and discomfort. Patient wanted to correct her malalignment as well as find a solution for her shaking teeth. Patient is said to be pre-diabetic and under medication for past 1 year.[/vc_column_text][vu_heading style=”2″ heading=”EXAMINATION OF THE PATIENT” subheading=”” alignment=”left” custom_colors=”” class=””][vc_column_text]On clinical examination, the patients lower anteriors appeared to be crowded and malaligned. The gum tissue surrounding the relative teeth seemed to have mild inflammation with bleeding on palpation. On radiological examination,OPG taken shows moderate generalized bone loss in all teeth except for the corresponding lower anteriors which considerably had slightly more bone resorption, due to poor oral maintenance of the patient. A thorough blood analysis revealed no systemic abnormalities. Blood glucose level was under control.[/vc_column_text][vu_heading style=”2″ heading=”TREATMENT PLAN” subheading=”” alignment=”left” custom_colors=”” class=””][vc_column_text]With regard to the patients concern on malalignment and mobility, Dr S M Balaji planned to extract the shaking teeth in the lower front region and replace the missing teeth with dental implants under local anesthesia. Patient was briefed about the procedure and consent was obtained.[/vc_column_text][vu_heading style=”2″ heading=”PROCEDURE” subheading=”” alignment=”left” custom_colors=”” class=””][vc_column_text]Under local anesthesia, the extraction of the corresponding lower front teeth was carried out following thorough irrigation of the extracted teeth socket. The gum tissue surrounding the site has been raised exposing the underlying jaw bone. Following that, dental implants of desired size were fixed in the bone. Final closure of the gum tissue was obtained with absorbable suture. A three day course of antibiotics and painkillers has been prescribed to the patient to cope up with the post- surgical mild discomfort. Patient was educated on the post-operative oral maintenance instructions to be followed at home. The patient was asked to report after 3 months for placement of the final prosthesis, to ensure the dental implants integrates well with the jaw bone and to attain maximum stability and retention of the fixed prosthesis. Meanwhile, a removable prosthesis has been given to the patient to replace the missing teeth for the time being.[/vc_column_text][vu_heading style=”2″ heading=”THE FINAL OUTCOME” subheading=”” alignment=”left” custom_colors=”” class=””][vc_column_text]The patient reported after 3 months for the final procedure. Post- operative OPG taken shows well osseointegrated dental implants. Hence the final impression was taken and bite trails were seen. A natural looking fixed prosthesis was fixed on the implant. The prosthetic teeth looked very real and well aligned with the patient’s natural teeth, enhancing the patients look and smile. The patient was very happy with the outcome, as it was all that she needed.[/vc_column_text][/vc_column][/vc_row][vc_row content_layout=”boxed” equal_height=”” animation_delay=”” disable=”” id=”” class=”” bg_type=”image” bg_image=”” color_overlay=”” enable_parallax=”” enable_pattern=””][vc_column layout=”normal” vertical_align=”top” animation_delay=”” width=”1/3″][vc_single_image image=”5969″ img_size=”full” add_caption=”yes”][/vc_column][vc_column layout=”normal” vertical_align=”top” animation_delay=”” width=”1/3″][vc_single_image image=”5970″ img_size=”full” add_caption=”yes”][/vc_column][vc_column layout=”normal” vertical_align=”top” animation_delay=”” width=”1/3″][vc_single_image image=”5971″ img_size=”full” add_caption=”yes”][/vc_column][/vc_row][vc_row content_layout=”boxed” equal_height=”” animation_delay=”” disable=”” id=”” class=”” bg_type=”image” bg_image=”” color_overlay=”” enable_parallax=”” enable_pattern=””][vc_column layout=”normal” vertical_align=”top” animation_delay=”” width=”1/3″][vc_single_image image=”5972″ img_size=”full” add_caption=”yes”][/vc_column][vc_column layout=”normal” vertical_align=”top” animation_delay=”” width=”1/3″][vc_single_image image=”5973″ img_size=”full” add_caption=”yes”][/vc_column][vc_column layout=”normal” vertical_align=”top” animation_delay=”” width=”1/3″][vc_single_image image=”5974″ img_size=”full” add_caption=”yes”][/vc_column][/vc_row][/vc_section]
Dental Implants and Ceramic Crowns for Smile Makeover
[vc_section content_layout=”full” animation_delay=”” disable=”” id=”” class=”” bg_type=”image” bg_image=”” color_overlay=”” enable_parallax=”” enable_pattern=””][vc_row content_layout=”boxed” equal_height=”” animation_delay=”” disable=”” id=”” class=”” bg_type=”image” bg_image=”” color_overlay=”” enable_parallax=”” enable_pattern=””][vc_column layout=”normal” vertical_align=”top” animation_delay=””][vu_heading style=”2″ heading=”PATIENT COMPLAINT” subheading=”” alignment=”left” custom_colors=”” class=””][vc_column_text]A 52 year old female approached our dental hospital, wanting to replace the missing teeth in her upper and lower anteriors. Patient gives a history of extraction of a couple of her upper and lower anteriors done due to severe mobility 5 years back which made it difficult for her to chew food. Since there was space between the front teeth, she was not able to pronounce few words properly, thus hampering her speech. She was worried that her gap would widen more in the future if left untreated. Her inability to have a proper oral function affected her well being. Patient gives a medical history of diabetes for the past 10 years and under medication.[/vc_column_text][vu_heading style=”2″ heading=”EXAMINATION” subheading=”” alignment=”left” custom_colors=”” class=””][vc_column_text]On clinical examination, the upper left central incisor, lower central incisors and a couple of her posterior teeth were all missing. The remaining upper and lower anteriors exhibhited grade2 mobility. On radiological examination OPG taken shows generalized bone loss with regard to periodontally week teeth. A thorough blood investigation revealed blood glucose level under control.[/vc_column_text][vu_heading style=”2″ heading=”TREATMENT PLAN” subheading=”” alignment=”left” custom_colors=”” class=””][vc_column_text]After complete examination of the patient and considering her demand to replace the missing upper and lower anteriors only, Dr.S.M.Balaji planned to extract the shaking teeth and replace it with dental implants under local anesthesia. The procedure was explained to the patient and approval was obtained to go ahead with the treatment plan.[/vc_column_text][vu_heading style=”2″ heading=”PRE- OPERATIVE FOLLOW-UP” subheading=”” alignment=”left” custom_colors=”” class=””][vc_column_text]Patient was asked to take antibiotics and painkillers for a period of 5 days. Patient was educated and motivated on home oral care regime. The dental implants would take a minimum duration of 3 months to completely osseointegrate with the jaw bone. Until then, a temporary prosthesis was given to the patient to replace the missing teeth.[/vc_column_text][vu_heading style=”2″ heading=”THE FINAL LOOK” subheading=”” alignment=”left” custom_colors=”” class=””][vc_column_text]Patient reported after 4 months. Post-operative x-ray (OPG) taken shows well consolidated dental implants with the jaw bone. Aesthetically natural looking ceramic prosthesis was fixed on to the implants, thus taking off the worrisome days of the patient. The patient was very much pleased with the look. She felt an immediate betterment in her speech. Having been satisfied with the outcome, patient showed keen interest to restore her missing posterior teeth with dental implants at a later date.[/vc_column_text][/vc_column][/vc_row][vc_row content_layout=”boxed” equal_height=”” animation_delay=”” disable=”” id=”” class=”” bg_type=”image” bg_image=”” color_overlay=”” enable_parallax=”” enable_pattern=””][vc_column layout=”normal” vertical_align=”top” animation_delay=”” width=”1/3″][vc_single_image image=”5941″ img_size=”full” add_caption=”yes”][/vc_column][vc_column layout=”normal” vertical_align=”top” animation_delay=”” width=”1/3″][vc_single_image image=”5942″ img_size=”full” add_caption=”yes”][/vc_column][vc_column layout=”normal” vertical_align=”top” animation_delay=”” width=”1/3″][vc_single_image image=”5943″ img_size=”full” add_caption=”yes”][/vc_column][/vc_row][vc_row content_layout=”boxed” equal_height=”” animation_delay=”” disable=”” id=”” class=”” bg_type=”image” bg_image=”” color_overlay=”” enable_parallax=”” enable_pattern=””][vc_column layout=”normal” vertical_align=”top” animation_delay=”” width=”1/3″][vc_single_image image=”5944″ img_size=”full” add_caption=”yes”][/vc_column][vc_column layout=”normal” vertical_align=”top” animation_delay=”” width=”1/3″][vc_single_image image=”5945″ img_size=”full” add_caption=”yes”][/vc_column][vc_column layout=”normal” vertical_align=”top” animation_delay=”” width=”1/3″][vc_single_image image=”5946″ img_size=”full” add_caption=”yes”][/vc_column][/vc_row][/vc_section]
Zygoma implants for Atrophic upper jaw
[vc_row content_layout=”boxed” equal_height=”” animation_delay=”” disable=”” id=”” class=”” bg_type=”image” bg_image=”” color_overlay=”” enable_parallax=”” enable_pattern=””][vc_column layout=”normal” vertical_align=”top” animation_delay=””][vc_column_text] PATIENT HISTORY A 60 year old female patient approached our dental hospital with a complaint of mobile prosthesis in her upper and lower jaw. Patient had a history of long standing mobile teeth due to debilitating periodontal pathology, following which she had undergone extraction of all her teeth. The patient said that she remained without teeth for a period of 2years. Later she had replaced her missing teeth with an implant-supported prosthesis done elsewhere. Patient stated that the prosthesis had been fixed in just a week after the implant placement. Within one month of having the prosthesis fixed, she started to experience pain and discomfort in the gum tissue surrounding the prosthesis in both upper and lower jaws. Subsequently, the prosthesis exhibited mobility. Also she grumbled upon the salty tasting liquid discharge from her gums. Due to the above reasons the patient was struggling to chew food. She was very upset with her oral health. She worried that the mobility would progress more if left untreated. She was desperate to get rid of the shaking prosthesis. Patient had no history of diabetes mellitus or any other adverse habits. EXAMINATION On clinical examination, the gums surrounding the implant prosthesis were swollen and tender on palpation. There was evident pus discharge and bleeding on examination. The implants in the upper and lower jaw exhibited mild mobility depicting a condition called ‘peri-implantitis’. “Peri-implantitis is an infection of the soft and hard tissues surrounding an osseointegrated implant, leading to the loss of supporting bone.” Pre-operative x-ray taken shows diffuse radiolucency around the implants in the upper and lower jaws indicating severe bone loss, owing to the mobility of the implants. TREATMENT PLAN On view of the patient’s condition and insistence of the patient, Dr. SM Balaji planned to remove the failed dental implants along with the prosthesis under local anesthesia, to relieve the patient from suffering further. Followed by replacement of missing teeth with removable denture. TREATMENT STAGE I Under local anesthesia the prosthesis in the upper and lower jaws were removed along with the infected dental implants. Patient was put on antibiotics to decrease the infection and to aid the healing of the gum tissues. Later Impression was taken and removable upper and lower dentures were delivered to the patient to replace her missing teeth temporarily. STAGE I REVIEW The patient returned after 4 months for review. The patient stated that she was not able to relish her meals, as the upper denture covered the palate. Although patient was managing with the removable dentures, she was insisting for a fixed option by which we could replace her missing teeth. OPG taken shows insufficient bone height in the upper posterior region, to support the conventional dental implant. With regard to the patient’s oral condition and need, Dr.S.M.Balaji decided to perform a graft less technique under general anesthesia, by anchoring the upper posterior dental implants in the zygomatic bone (cheek bone) and with additional conventional dental implants where there is sufficient bone, under general anesthesia thereby providing a brilliant alternative for teeth replacement. ZYGOMA IMPLANT For severe bone resorption, zygomatic implants are excellent treatment of choice, as it would shorten time and lengthy treatment procedure involved in bone grafting techniques. Zygoma bone provides great stability and retention for the dental implant. It aids in high primary stability for immediate function. The surgical procedure was clearly explained to the patient and consent was obtained. STAGE II TREATMENT Under general anesthesia, the gum tissue is cut and elevated in the upper and lower jaw bone exposing the underlying bone. Followed by this a small oval window is cut open in the right upper lateral wall of the sinus close to the zygomatic bone (cheek bone). A membrane is exposed on the other side of the bone which acts as a barrier between the sinus and the jaw. This membrane is then gently lifted away from the area creating a space through which the zygoma implant is placed. The zygoma implant is drilled with precision, ensuring not to penetrate the membrane. Similarly, the zygoma implant was fixed in the left upper posterior region. In addition to this, conventional implants of varying height and depth were placed in the anterior region of the upper jaw and lower jaw. POST-SURGICAL PROTOCOL The patient was put on medication for 5 days to cope up with the mild pain and discomfort. Home care instructions were given. Patient was asked to report after 6 months for final prosthesis. This duration is for the dental implants to completely osseointegrate with the jaw bone. Meanwhile, patient was given a light weight provisional prosthesis. THE HAPPY PATIENT Patient reported after 6 months. Post-operative OPG taken shows zygomatic implants and conventional implants, well integrated and positioned in the jaw bone. Final impression was taken. After a couple of bite trials ensuring no traumatic bite, natural looking fixed hybrid prosthesis was fixed onto the dental implants. There was an immediate remarkable change in the patient’s speech and appearance which boosted her confidence. The patient and her family members were very happy with the outcome. Patient is on a regular follow up. [/vc_column_text][/vc_column][/vc_row][vc_row content_layout=”boxed” equal_height=”” animation_delay=”” disable=”” id=”” class=”” bg_type=”image” bg_image=”” color_overlay=”” enable_parallax=”” enable_pattern=””][vc_column layout=”normal” vertical_align=”top” animation_delay=”” width=”1/3″][vc_single_image image=”5824″ img_size=”full” add_caption=”yes”][/vc_column][vc_column layout=”normal” vertical_align=”top” animation_delay=”” width=”1/3″][vc_single_image image=”5825″ img_size=”full” add_caption=”yes”][/vc_column][vc_column layout=”normal” vertical_align=”top” animation_delay=”” width=”1/3″][vc_single_image image=”5827″ img_size=”full” add_caption=”yes”][/vc_column][/vc_row][vc_row content_layout=”boxed” equal_height=”” animation_delay=”” disable=”” id=”” class=”” bg_type=”image” bg_image=”” color_overlay=”” enable_parallax=”” enable_pattern=””][vc_column layout=”normal” vertical_align=”top” animation_delay=”” width=”1/3″][vc_single_image image=”5829″ img_size=”full” add_caption=”yes”][/vc_column][vc_column layout=”normal” vertical_align=”top” animation_delay=”” width=”1/3″][vc_single_image image=”5833″ img_size=”full” add_caption=”yes”][/vc_column][vc_column layout=”normal” vertical_align=”top” animation_delay=”” width=”1/3″][vc_single_image image=”5831″ img_size=”full” add_caption=”yes”][/vc_column][/vc_row][vc_row content_layout=”boxed” equal_height=”” animation_delay=”” disable=”” id=”” class=”” bg_type=”image” bg_image=”” color_overlay=”” enable_parallax=”” enable_pattern=””][vc_column layout=”normal” vertical_align=”top” animation_delay=”” width=”1/3″][vc_single_image image=”5828″ img_size=”full” add_caption=”yes”][/vc_column][vc_column layout=”normal” vertical_align=”top” animation_delay=”” width=”1/3″][vc_single_image image=”5830″ img_size=”full” add_caption=”yes”][/vc_column][vc_column layout=”normal” vertical_align=”top” animation_delay=”” width=”1/3″][/vc_column][/vc_row]