Clinical case 849

The 32 year old patient came to the clinic with both physiognomic and functional issues. The upper incisors presented 2-3 degree of mobility and gum recession on 2/3 of the root length. The lower incisors presented a second degree of mobility and an about 2-3 mm gum recession.

The patient also suffered of periodontitis, a very advanced stage for his age, claiming serious gum bleedings.

We decided to perform surgery for all teeth in order to treat periodontitis and to extract the four upper incisors, which could not be saved.

We also decided not to extract the lower incisors, as the doctors from USA suggested (the patient lived in USA), but to perform a guided bone regeneration.

The surgeries were complex because we had to complete the treatment in just two stages.

The first stage meant the extraction of the four upper incisors and the immediate placement of four dental implants and, also intraoperative, the treatment of periodontitis for the upper teeth, including bone augmentation for the required areas.

On the implants we have placed postoperative temporary crowns so the patient left the clinic as if he has not suffered any surgery. The following stage implied the treatment of periodontitis for all lower teeth and bone augmentation, including treatment with Emdogain and BioGide Perio membrane, saving the front teeth that the colleagues from USA intended to extract and also the molar of the right side which had a very deep (of about 10 mm) periodontal pocket.

Two months later the Zirconia crowns have been cemented, obtaining a very good result from both aesthetic and functional points of view.