Elimination of dental foci, dental implant surgery, the fabrication of metal ceramic full-arch bridge and screw-retained implant crowns
Treatment phase I – Tartar removal, elimination of dental foci, fabrication of provisional denture
Our male patient aged 55 reported to our clinic with the following requests:
- He wanted to have his old neglected bridges replaced.
- Some of his teeth were giving him issues, and he wanted to have them treated.
- He complained of foul breath.
- Some of his lower left teeth had recently been extracted and he wanted to have these replaced.
- He wanted to have dental implants and fixed restorations.
First treatment (3 workdays) – tooth extractions
A panoramic radiograph was recorded at the first consultation and the state of the teeth thoroughly examined.
The first examinations revealed that his lower molars were due for removal on account of tooth decay having formed under the crowns and inflammations. These inflammations are dental foci which need to be treated by all means since they may give rise to other non-dental issues (such as hair loss, dermatological, cardiological complaints). Two of his upper left molars were also due for removal being as they were beyond repair due to the great extent of horizontal and vertical bone resorption.
These tidings did not catch our patient unawares, although he was trustful that this could be avoided. He suspected major problems with his other teeth as well. He was even open to having implants mounted as long as it was required for a fixed tooth restoration. When restoring masticatory function, teeth up until the first molar need to be replaced, so that bits of food can be chewed properly to prevent temporomandibular joint complaints and digestive disorders.
In the first step tartar removal and polishing was performed due to the presence of a heavy pile-up of sub and supragingival tartar in order to prevent bacteria from entering the tooth extraction wounds and cause infection. The decayed teeth were removed at the first treatment, that is, the dental foci were eliminated. Following tooth extractions, a provisional denture was prepared for the lower jaw bone to replace missing teeth for the time of healing. Our patient only needed his provisional denture for work, when among people, and, complying with our request, he would forgo wearing it at other times. He was finally advised of the method and importance of cleaning his denture at home.
The treatment can be resumed after 3 months’ healing time with the installation of implants, once the bone at the sites of the tooth extractions has healed. To examine bone mass a CBCT (Cone beam computed tomography will be required.