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Severe Head and Face Trauma with Associated Tooth and Supporting Bone Loss
Diagnosis
Patient #15 lost 5 upper front teeth and so much supporting bone that implants could not be placed due to insufficient bone. There was so much bone missing that a conventional graft would be unsuccessful. This young man wanted replacement teeth that were not removable. He was willing to try this new procedure.
Treatment
A very new technique that moves bone into a deficient area very slowly which is called "distraction osteogenesis" was used in this situation. The bone was surgically sectioned and moved daily towards the deficient area filling that area with the bone that once was there supporting the teeth. The body heals the area where the bone was moved from by filling in bone in the defect. The technique works well because the blood supply is not interrupted, providing the needed nutrients for healing.
One of the lower incisors was lost in the accident and the space was closed orthodontically (using braces). After the "distraction osteogenesis" was completed the four implants were placed to support the five missing teeth.
The procedure allowed the implants to be placed close enough to build a screw retained prosthesis that replaced those missing teeth. The prosthesis was very cosmetic and functional the patient was extremely pleased with the outcome.
Future Treatment
Cosmetic bleaching was continued to "touch up" every month or so. The patient will return every 6 months for a checkup and x-rays every year to monitor the bone support. The patient must wear his retainer to insure the lower teeth don't relapse. One of the great things about implants is that the bone is stimulated and should remain healthy providing the prosthesis is adequately cleaned and is not abused by overloading. I am very proud of this case because it is one of the first of these cases done in Kentucky. We do not know the average life expectancy of the implants. The average life expectancy of the metal ceramic crowns is 12 to 14 years.
Contents © 2004 Russ Williamson, DMD All Rights Reserved