Deep Cleaning and Implants for Gum Disease

Mr. Shi, in his early forties, has severe gum disease, particularly 2 front teeth (Fig.1-3: #1,1).  Their surrounding gums are reddish and swollen (Fig.1,2 arrows).  These 2 teeth are very loose, because there is a little bone to support them (Fig.3: red arrows).  They need extraction and implants. 

First of all, gum disease should be taken care of.  Deep cleaning gets done and home care implemented (floss, minibrush, and prescription mouth rinse (Chlorhexidine)).  Surprisingly, the reddish and swollen gums are almost gone in five days (Fig.4,5, as compared to Fig.1,2).  The 2 black boxed areas in Fig.6 represent 2 implants to replace the 2 loose teeth.  The implants are much longer than the teeth.  The extra portion (red arrows) is inserted in the solid bone.  The implants are expected to be stable.

Immediately after extraction, two implants (Fig.9 I) are placed with good length in contact with bone (red arrows, compare to Fig.3 or 6).  The implants are so strong that 2 temporary crowns are cemented instantly (Fig.7,8: T).  Mr. Shi walks out of clinic with smile and confidence.

One week later, the patient returns for follow up and getting a few cavities filled.  The infection prior to implantation is completely gone (Fig.10,11: <).  More importantly Mr. Shi has kept his teeth and implants super clean since the treatment.

The patient comes back for follow up one month and a half after implant surgery.  The gums around the implants look healthy.  No infection comes back (Fig.12,13: <).

Four months after implant surgery, these two implants remain stable (Fig.14: I, longer and wider than the neighboring tooth (2)).  Final crowns are seated (Fig.15,16).  There is no sign of infection.  Mr. Shi is pleased. 

One year after crown seating, the bone between the implants seems to have grown down (Fig.17 arrow).  The thick bone (**) appears to be closer to the implant than that in Fig.14.

Xin Wei, DDS, PhD, MS 1st edition 07/30/2013, last revision 01/06/2015