62 yrs female patient presented at the clinic suffering from an inability to feed herself for the last few years and lack of confidence in social situations due to the severe caries in front teeth. Additionally she was suffering from recurrent abscess formation. The patient had visited other clinic,all of which had done failed restoration and inappropriate RCT and restoration. She was looking for fixed and esthetic teeth with strong and functional. The patient medical history was clear. A clinical and radiological examination was carried out to assess the PT's suitability for implant placement. On the upper jaw she decayed and retained roots in the front region.In order to provide the pt with an accurate diagnosis and to evaluate bone level and quality for potential implant placement,a 3d cbct Scan was performed. The quality of the alveolar bone seemed adequate for implants placement and no extra bone graft required for implant surgery. Treatment planing--- The plan was to remove all the decayed front teeth and placement of six implants,3 side by side and then followed by fabrication of screw retained zirconia bridge after healing period of 4 months
fig 1 - Baseline photograph when patient presented herself in the clinic,all front teeth decayed and damaged
fig 2 - Decayed and damaged teeth removed side by side and implants placed
fig 3 - sutures given and instructions given to follow after 1 week
fig 4 - Healing abutments removed after 4 months and impression taken for fabrication of screw retained anterior bridge
fig 5 - Anterior screw retained bridge applied and occlusion checked with lower teeth
fig 6 - Final prosthetic anterior bridge was plan to hide all the implants hole palatly so that it is not visible from the front side
fig 7 - Finally a happy and healthy smile provideed to the patient.
A 65 yr old lady was referred to us by her relative, she came all the way from Muscat, Oman. Her problem was that she was not at all comfortable with her removable dentures. She wanted a permanent solution.
At Smritiraj Dentistry, Dr Raj Tiwary did a full mouth fixed implant rehabilitation. It took her 3-4 days to gain her natural smile
Early morning we received a call from a lady who was very scared and complaining about her RCT treated broken tooth. Her front tooth was broken and she had to attend a party very next day. The patient wasn't even in condition to open her mouth properly. She could barely talk. Since her front tooth that had broken she was jittery and very worried about her smile and overall look at the party
The assistant called the lady to the clinic for an immediate consultation with Dr Raj Tiwary,
We had administered an Treatment plan
Step : CBCT was taken in our centre. Reports showed only root piece left inside the tooth socket. So, treatment was planned. In her case scenario the plan was to remove the left out root piece followed by implant placement & immediate capping.
Step 1 : X-ray taken.
Step 2 : Root piece removed under LA without pain.
Step 3 : Implant measurement compared with root piece.
Step 4 : Implant placement was done in the same socket.
Step 5 : White socket abutment placed over implant.
Step 6 : Final carving & build up done.
Eventually she got her smile back in only 2 hours and was very happy. Now she could smile confidently and happily attend the party scheduled next day.
Total teeth loss is a common phenomenon in patients with poor bone integrity. The reasons leading to this can be various, old age being the most common. One such patient came to us for help who had lost majority of his teeth. After through examination and discussions with experts we suggested the use of implant supported dentures. The two main reasons were
1. In this case there was no scope for conventional dentures as the preliminary support system of adjacent teeth was not available.
2. Individual implants in place of the missing teeth were not cost-effective for the patient.
For implant supported dentures we follow the same surgical process as individual implants, but instead of a single crown, an entire denture is placed on the implant. This was done to make the prosthesis more stable, easily detachable (the patient himself could do it), and provide good support. Implant supported denture is the best solution for anyone who is suffering from total teeth loss.
This patient visited us with an acute toothache and our diagnosis revealed that two of his molars in the upper left region were severely infected. Tooth infection generally occurs due to cavity and tooth decay. To save this patient’s adjoining teeth, the underlying jaw bone, and the surrounding gum, we had to remove both the molars.
However, owing to the absence of molars, the patient was naturally having a problem in chewing as these types of teeth help us to grind our food just before swallowing. 5 months later, from the date of the removal, we placed two Mirell implants (a brand we recommend) in place of the missing teeth. The patient will now take 5-6 months more to heal post osteointegration after which we will place the crown on them. He soon will have his molar functions resumed and his oral structure will be back to normal.
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