Pain Relief
Just a Smile Away
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Pre-operative frontal view and profile reveal a dental condition that detracts from otherwise attractive features.

or developing a definitive plan of care. She was in pain, depressed by the way her teeth appeared, and uncertain of who to turn to for help when a friend recommended that she see a prosthodontist for evaluation. She made the appointment.

Lori underwent a comprehensive clinical and radiographic examination including a review of a detailed medical history and evaluation of study casts for an occlusal analysis. Based on these findings, she was referred to Pi Dental Center for further evaluation to consider a full arch fixed implant supported reconstruction for both jaws using the Teeth in a DayTM protocol.

Lori had additional records, photographs from every angle, working casts and an i-CAT Cone Beam CT-Scan made in one visit. Her medical history was contributory to her dental condition since she suffered with a kidney defect causing ureter reflux which required surgical treatment as a young child. She reported having Hashimoto's Thyroiditis (an autoimmune disease), eosinophillic gastroenteritis, IBS (irritable bowel syndrome), anemia and hypertension. She was under the care of many physicians for these conditions. From her late high school years until her mid-twenties, she suffered from ulcers and gastrointestinal problems resulting in two separate incidents of daily vomiting lasting three and nine months, respectively. It is likely that these multiple conditions contributed heavily to the demise of her enamel and the resultant tooth loss and severe dental complications.

Due to decay, abscesses, periodontal disease, bone loss, infection, malocclusion and lack of function, the prosthodontist recommended extraction of all remaining teeth and reconstruction of both arches with full arch fixed prostheses supported by osseointegrated dental implants. Lori requested that she be "put to sleep" during treatment. Two surgeries were planned using the Teeth In A DayTM (TIAD) protocol with the patient under general anesthesia. There was one recovery day in between surgeries. On the first surgical day, the remaining fifteen maxillary and mandibular teeth were extracted and all infection was removed. Seven Brånemark Ti-UniteTM surfaced implants were then placed in the lower jaw. Bone harvested during the implant placement was used for grafting. Platelet-rich plasma (PRP) coated the implants following the Rassmussen spin technique. The mandibular denture was modified to create the TIAD fixed teeth. A whole new look was given to the patient at the same visit with a new upper denture. Post-operative instructions and medications were given.

Palatal view of missing maxillary posterior teeth

Retracted view of maxillary and mandibular arches

Numerous missing teeth in the manidbular arch

Spring 2005 Newsletter
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