Chief Complain : Patient Complains of mutiple missing teeth & requests for fixed teeth.
On Examination : Patient was having existing unstable dentures. Patient was not statisfied with present upper & Lower Partial Dentures.
Diagnosis : Patient was suffering from Generalised Periodontitis with bone loss. Existing Dentures were ill fitting.
Treatment: After thorough evaluation it was decided to do total extraction (remove all existing teeth) & provide patient with Implant supported Hybrid Denture (Fixed Teeth). Total 3 surgeries were required to place 13 implants. One implant on the left side partially failed due to bone resorption on the buccal side, hence implant was left untouched (sleeping) to avoid damage to bone by forceful removal. We have placed Nobel Replace Select Implants & Hybrid Denture were made by acrylisation of Procera Implant Bridge (PIB) for both upper & lower Jaw. PIB for upper jaw needed to be repeated due to error in impression making.
Doctors: Dr. Mrugank Shah & Dr. Sachin Gupta. Under Guidance of Dr. Kumarswamy & Dr. Kanir Bhatia.
CASE - 02
Time Frame : July 2008 to Nov 2009
Chief Complain : Patient was referred to me by my old patient. Patient had 24 existing crowns & bridges.She had undergone a couple of Root Canal Treatments (RCT), Fillings, & Extractions earlier.
She used to complain of intermittent radiating pain in the mouth, occasional swellings & bad breath. She was not happy with the aesthetics of the existing teeth.
On Examination : After thorough examination & radiographic evaluation, we decided to remove the bridges and check below the crowns.
Diagnosis : On removing all crowns & bridges it was concluded that patient would require a full mouth Rehabilitation (Restoration) which would involve couple of root canals, extractions, implants, fillings and post & Core.
Treatment : We implemented a conservative approach & tried to preserve as many teeth as possible. Teeth which were treated by previous doctor but asymptomatic where left untouched. In brief, the following treatment was done by Me (Dr. Mrugank Shah) :
• Teeth which were asymptomatic & left untouched are 22,26
• 4 extractions (tooth No. 34,35,43,45)
• 10 Root Canal Treatments for tooth no.17,15,13,12,21,31,32,33,41,42. RCT for tooth no 17 has been done by Dr. Purvi Pandya (Endodontist)
• 15 Light Cured Composite /Glass Inomer Cement Fillings, for 15,13,12,11,21,22,23,25,26,31,32,33,41,42,47 as per clinical situation.
• 1 Silver Filliing for tooth no 17
• 3 Implants were placed (Uniti from Equinox) in the region of tooth no 43,44,46.
• 3 Unit Implant Supported Bridge, for tooth no 44,45,46.
• 1 Unit Implant Supported Crown for tooth no 43.
• 1 Unit Metal Crown for tooth no 47.
• 6 Unit Ceramic Bridges in the region of 15,14,13 & 23,24,25.
• 9 Unit Ceramic Crowns for tooth no.12,11,21,22,31,32,33,41,42
• Cleaning / Oral prophylaxis of teeth. Oral Hygine Instruction & follow up check up done.
Due to unavoidable circumstances, implants & restorations on the left side is pending (to be completed later). Patient is happy as is able to eat from the right side and flaunt a confident smile.
Doctors : Dr. Mrugank Shah & Dr. Sachin Gupta. Under Guidance of Dr. Kumarswamy & Dr. Kanir Bhatia.