Mr. Smith has been doing great with 4 dental implants (at the sites of #2,3,4, and 30 in Fig.1) for 3 years. But his bridge (#6-8) is going down. The bridge was used to restore missing tooth of #7. The bridge at one of supporting teeth (#6 in Fig.2) is loose. It appears that this tooth is breaking down (*). When the bridge is partially removed, the tooth #6 is confirmed to be broken down by cavity to its root (Fig.3). This tooth has to be taken out. Since infection is not so severe, an implant is placed immediately after tooth removal (Fig.4 I). The implant is as long and large as the tooth (Fig.3) it replaces so that it can stay in the jaw tightly. Surprisingly, Mr. Smith (at the age of 73) is doing great after surgery. Sutures are in place, but there is no sign of infection around the implant at the site of #6 one week after surgery (Fig. 5), as compared to the same area (#6) in Fig.3. Two months later an implant is placed in the missing tooth site of #7 where the bone is skinny (Fig.3: 7) using a bone expansion technique. Finally the bone at #7 is shown to be no longer collapsing when #6 and 7 crowns are cemented over the implants (Fig.6 as compared to Fig.3, 5).
Before the final cementation, we discuss a plan to do 3 more implants at the sites of #12, 13, and 14. The tooth at #12 is already gone, while the tooth #13 has also broken down to its root. The last tooth #14 has root infection after multiple treatment. We will most likely see you in near future.
Xin Wei, DDS, PhD, MS 1st edition 12/20/2011, last revision 09/28/2012