Case of the Month

Congenitally Missing Lateral Incisors.

A Case Presentation by Carlos Pria, DMD. (University of Oklahoma, Graduate Periodontics)

A 21 year old Hispanic female presents with congenitally missing lateral incisors. Medical health is non contributory. Patient is a non-smoker and presents no family history of systemic disease. Her chief compliant was “I want to replace my missing teeth”. Periodontal exam revealed localized mild gingivitis, probing depth range from 1-3 mm, negative recession and mobility and missing teeth #7 and #10. Her home care was excellent. The treatment plan to replace the missing laterals with dental implants was presented to the patient. Patient consented to the surgery...

Crestal incisions were made along the edentulous ridge; full thickness flap was reflected with a blunt elevator.

Osteotomies were prepared following protocol. The patients continued wearing the removable temporary prosthesis. After the soft tissue healed the patient was brought back to the clinic and temporary restorations were fabricated to mold the soft tissue contours.

At 4 months, the implants showed osseointegration and the patient were sent to the restoring dentist for the final restorations. The final restorations were placed at the end of the fifth month. Electro surgery was used for aesthetic contouring.

At subsequent follow up appointments the tissues showed excellent health and the patient express her gratitude. 

Discussion: With her chief compliant in mind, this case could be successfully treated by different approaches. These include implant placement, fix prosthodontics with ovate pontic site development and as a last approach a removable appliance. The decision was made to place individual implants due to the age of the patient and excellent height of bone as well as soft tissue. The challenging aspect of the case lies in the ridge width deficiency. For that reason 3.0 one piece dental implants were used creating a surgical challenge due to the strict angulations and positioning protocols.

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Aesthetic Rehab using Implants by David H. Yu, DDS, MS

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