In 2010, a patient was referred for the removal of Tooth #5 due to severe periodontal disease. Included is the x-ray and the photographs taken at the time of the tooth removal. There was severe bone loss involving this tooth as well as other teeth in her dentition. The tooth loss on #4 is visible.
The patient returned with a recommendation to take out Tooth #4. Included is the 2017 x-ray taken of Tooth #4 and #5 (#5 being the implant). There was no bone at all noted on Tooth #4. The defect went beyond the apex and affected the distal of the implant.
There are two categories of people who need implants: those people who have lost teeth because of periodontal disease and those who have lost teeth due to caries and/or are fully edentulous.
The biology of the patients with periodontal history as well as active periodontitis is different and must be approached differently. The eradication of the periodontal disease throughout the mouth should precede the placement of implants and certainly maintenance afterwards in a patient like this is critical to prevent the catastrophic dental outcome that occurred.
As always, I appreciate your feedback.
Victor M. Sternberg, D.M.D.
Dental Office of:
Victor M. Sternberg, D.M.D., PC
Westchester Center of Periodontal and Implant Excellence
141 North State Road
Briarcliff Manor, NY 10510