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Project Details
CONCERN
Missing tooth
TEAM
Prof Shahdad + Dr Myint
Services
Single Implant Crown
Duration
2.5-3 months
PROJECT OVERVIEW
This patient was referred by her orthodontist as her tooth was sadly being resorbed (i.e disolving itself due to inflammatory processes that is not her fault). Sometimes life is not fair and we really wanted to help her out.
The prognosis was hopeless for the tooth despite repeated root canal treatments in the past. It was decided it needed to be extracted and replaced with an implant. But she is so young with potential over 70 years left of life.
challenges
It is notorious amongst dentist that replacing a single tooth in the aesthetic zone is so hard because if you get the gum shapes wrong, the tooth shape wrong, the colour off, it will be obvious and stick out like a sore thumb. If complications arise then the situation could be disastrous. Plus she has a very high lip smile line showing everything with nothing to hide under her lips. This is recognised as a high risk case.
How can we provide an implant that will last as long as possible in her lifetime without complications or disease? How can we get the teeth to look the same and the gum dimensions.
solutions
Prof Shahdad and I will always do a plan of the implant surgery based on her teeth shape, the design of the proposed new tooth and the bone CT scan to see the anatomy we are dealing with.
Once the tooth is removed, depending on risk levels we will decide whether to place the implant immediately at the same time of removing the tooth or 2 months after. Although it may be nice to do things quickly, you can not control healing as it is biological, you can only encourage and sometimes doing too much is too much for the body. For such a young patient would you take the risk? We felt especially with our decades of experience that a 2 month wait to place the implant was best, and allow the gums to heal to have a cleaner surgery. We then routinely do bone grafting to give the volume of the gums but also to create bone to support the implant.
After healing Michael reassessed the shapes of the teeth and found that the middle teeth looked too rectangular and felt a more triangular shape would be suited. The patient agreed so Michael provided a composite edge bonding to the other middle tooth where you can see below looks more triangular on the right. With his lab technician he created a new implant crown after shaping the gums to the a nice scalloped natural looking shape.
impact
This case is now 8 years old and a lot can happen during that time. This patient has forgotten about the worries of losing her tooth and has enjoyed 8 years of travels, food and social life without worrying about her tooth. Memories to be made and the implant is doing really well looking healthy both during her check up and on the x-rays.
100%
Confidence improved
10/10
High risk
9years
Since treatment completed
100%
Patient satisfaction
