A 45 year old female patient from Erode approached us with a complaint of discolored upper front tooth and few teeth shaking with gum infection. Patient gave a history of trauma in her upper front tooth during her childhood, during that time she was asymptomatic, as days and years goes on she noticed that her tooth got discolored more and more severe. After a couple of years of discoloration she started having pain in her tooth which affected his normal well being, also patient gave a history of bleeding gums since 6 months. Patient did not undergo any dental treatment since then, we questioned the patient and her daughter to explain the reason, then we came to know that the patient is having fear of pain in dental procedures(particularly with needles and injections),even with the normal teeth cleaning procedure she was having fear. Patient and her daughter stressed that she wants a painless dental treatment with quick recovery and finally approached us seeking treatment.
ON CLINICAL EXAMINATION
The discolored tooth was tender on palpation and percussion, the teeth next to the discolored tooth was grade 2 mobile, all her remaining teeth showed generalised mobility with severe calculus and tartar formation, with severe bleeding in her gums.
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ON CLINICAL EXAMINATION
The discolored tooth was tender on palpation and percussion, the teeth next to the discolored tooth was grade 2 mobile, all her remaining teeth showed generalised mobility with severe calculus and tartar formation, with severe bleeding in her gums.
ON RADIOGRAPHIC EXAMINATION
There was severe bone loss with periapical lesion and pus formation in discolored tooth and the tooth next to it. Generalised bone loss in all her existing natural teeth.
Preoperative OPG showing periapical pathology and bone loss
TREATMENT PLAN
After complete clinical and radiographic examination a comprehensive treatment plan was discussed with the patient
1.to extract the discolored tooth and tooth next to it with severe bone loss under local anesthesia(STA painless anesthesia) and replacing it with 2 basal dental implants followed by giving provisional crown on the same day.
2. full mouth scaling followed by LANAP(Laser Assisted New Attachment Procedure) and DTR (Disclusion Time Reduction) to strengthen her gums and balance her bite in two sittings.
PROCEDURE
DAY 1 - dental implant placement and 1st sitting laser treatment(LANAP) under local anesthesia(STA- computer assisted painless injection technique) followed by 3D digital scanning(digital impression) for crown fixing
Postoperative instructions and medications
POSTOPERATIVE OPG - showing accurate placement of dental implant at appropriate sites
3D DIGITAL SCANNING
AFTER LASER GUM TREATMENT
DAY 2 - 2nd sitting laser gum treatment and DTR followed by crown fixing and smile designing to close the gaps in the upper front teeth
Finally CAD CAM milled PMMA bridge was fixed over the implants.We had given a completely painless treatment throughout the procedure and the prosthesis we fixed had given a esthetically pleasing pleasing appearance to the patient and she was fully satisfied both functionally and esthetically.
Patient was informed to come for regular followups and to follow the postoperative instructions and asked to report us after 4 - 6 months of healing period to change her provisional crowns to permanent zirconium crowns.
OUR HAPPY PATIENT WITH HAPPY SMILE
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