Full mouth rehabilitations (rehabs) can be some of the most rewarding experiences, but require an immense amount of patience on everyone’s account, compliance, and good healing. This case in particular involved multiple failing endodontically treated teeth in conjunction with peri-apical abscesses which resulted in large amounts of bone loss prior to initiation of treatment.
After long discussions with the patient and preparations, we all elected to move forward with removal of the failing teeth, full debridement of surgical site, placement of immediate implants along with buccal grafting. This undoubtedly was a lot to ask of both the patient and the site, but as we will see, the results were great! Much of the success can be attributed to the patient’s compliance and diligence when following post-op directions. The timeline of events began on March 22, 2011 and commenced at just under a year.
After healing of the initial phase we were able to grow enough bone that it was necessary to remove some of the ridge to find and access the implants. Afterwards the healing around implant #10 yielded a deficiency in keratinized tissue and a bit of an alteration in gingival contour. This was discussed with the patient that grafting should take place prior but could be accomplished after final restoration. The patient made it clear that she wanted some slight imperfections of the teeth to obtain a “natural” look and did not want to have the perfect smile. Needless to say, she was ecstatic at the results.
We will wait for papilla formation between the new restorations and will continue to watch the tissue associated with #10, but for now she is 1 week into the restorations and can’t stop smiling!
A very special thanks to Dr. John Miller in Aspen who guided the restorative treatment and final restorations.