This is case report of our 32 year old male patient who approached us with a complaint of severe pain in upper front teeth since 1 month. On questioning about the previous dental history, patient gave a history of 2 root canal treated teeth done 8 years back, and tooth supported metal ceramic crown was given to the patient. The other root canal treated tooth was asymptomatic. Patient was not able to speak, that even the tongue pressure over the tooth while speaking and chewing was giving severe pain to the patient, also the patient was not able brush his teeth. Patient itself came to know that the root canal treated teeth was reinfected. then we clearly explained that reinfection in root canal treated teeth is a normal complication and that too it depends on aggressive nature of the bacteria, patient finally understood the current situation of his painful teeth and asked for a permanent solution that would improve his well being.
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ON CLINICAL EXAMINATION
The tooth was tender on percussion and palpation of surrounding tissues, adjacent tooth was asymptomatic and there was no tender on palpation and percussion.
ON RADIOGRAPHIC EXAMINATION
A periapical pathology indicating pus formation around the apex of the teeth was noticed and mild to moderate bone loss was noticed around the concerned teeth
3D(CBCT) cross section showing the presence of periapical pathology around the apex of the tooth
TREATMENT PLAN
After complete clinical and radiographic analysis,, treatment plan was discussed with the patient, first extraction of painful root canal treated tooth followed by replacemnet with basal dental implants in a day and giving connected tooth supported PMMA crown on the same day of implant surgery.
TREATMENT PROCEDURE
Before starting implant and tooth removal procedure, tooth supported metal ceramic crown was removed followed by extraction and implant placement procedure under local anesthesia.
IMMEDIATE POSTOPERATIVE OPG
Following the implant placement procedure, 3D digital scanning using imedit500 intra oral scanning was done and tooth and implant supported PMMA bridge was fixed on the same day of surgery
3D DIGITAL SCANNING
PMMA bridge fixing -
A final outcome, in which the prosthesis is natural looking and mimicks tha adjacent teeth both shadewise and contourwise, and the patient was extremely happy with the final outcome '
Patient was fully satisfied with his appearnce and left back to banglore, and he was asked to report us after 4-6 months of healing period, for changing his provisional(temporary crowns) to permanent zirconium crowns.
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