When I first met Laurie, she was 15 and in the middle of orthodontic treatment. Her upper left canine tooth was impacted (hidden in the bone and not in a position to erupt.) We determined that the tooth could not be saved and we elected to extract it and have an implant placed. The tooth was removed and a bone graft placed. The adjacent teeth were repositioned orthodontically so there would be enough room for the implant. The implant was placed and it was allowed to integrate to the bone. During this time Laurie wore a flipper type partial denture to replace the missing tooth. Once the implant was integrated, the implant was exposed and a screwed in temporary implant crown was placed.
The photos below show the space where the tooth was missing and the temporary crown in place. The crown looks terrific – but the permanent crown will look even better. Laurie is thrilled not to have to wear the removable denture anymore. Once further healing of the surrounding gum tissue takes place we will place the final implant abutment and crown.
Laurie just left for college, but she will be back in Coram for Thanksgiving when we will place a permanent implant crown. This type of dental treatment is complex and cannot be rushed – it takes a lot of planning and coordination among myself as restorative dentist, the orthodontist, the oral surgeon and periodontist. But is the wait worth it? You bet!
Look at all of the calculus (tartar) and plaque on the inside of these front teeth (top photo). See how we removed the deposits with an in-office scaling and polishing (bottom photo). Calculus like this can build up very quickly with improper homecare. The deposits on the teeth attract harmful bacteria and their acidic byproducts. This causes irritation and inflammation of the gum tissue. See how red and swollen the gums are in the top photo. These gums will bleed as soon as touched. The bone is also attacked and begins to resorb, or dissolve. The tooth then has less bony support and, in time, the tooth will loosen and fall out.
The bottom photo was taken on the same visit after scaling and polishing. The gums look healthier – less red and swollen. If caught in time, if the patient develops meticulous brushing and flossing habits, if he returns for regular dental maintenance visits, the gums and bone will heal and he will keep his teeth. If not, he will be a candidate for implants or a denture. Don’t let this happen to you!