Perio compromised anteriors

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Posted on By bruce birchenough In Periodontics

60 yo white male initially presented to me as a new patient recently. Extensive bone loss max anteriors but patient was asymptomatic and unaware of severity. Concerned about further loss of bone but if teeth are extracted I will have a huge area defect of soft and hard tissue to replace with implant treatment. Patient does not want a removeable appliance long term. My thoughts were to force erupt the 4 anteriors to bring bone and soft tissue with the teeth, then either splint crown 7-10 or reevaluate for implants. Thoughts/comments?




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5 Comments

Bruce; Ortho extrusion will probably work well followed by splinting of the anterior teeth but will most likely require endodontic therapy and proper intra-ortho occlusal adjustments to prevent trauma during movement. Can be done and work well here. Even without orthodontics, occlusal adjustment and splinting will help maintain dentition. Regards Mo


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Thanks Mo. A follow up question. Would your preference be to maintain these teeth in their current position with occlusal adjustment and splinting or are we better off with ortho eruption to improve long term bone/soft tissue?


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Really a clinical choice...depends on several factors. Position, occlusion, gingival health, stability and esthetics.


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Placement of implants in patients with periodontal disease is not a treatment that should be done without a full periodontal assessment and stabilisation of periodontal disease first. This review considers the risk of placing implants in patients with aggressive and chronic periodontitis.


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Actually, splinting crowns 7-10 or reevaluating for implants is a good idea, but you should seek advice from a dentist.


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