Consultation Implant

Referred from Dr. Emily Carter for evaluation for dental implants. Chief Complaint: - Patient presents with missing tooth #19, duration of 6 months. History of Presenting Complaints: - Patient reports the tooth was extracted due to a fracture. Patient reports no pain or discomfort currently. Patient reports they would like to replace the missing tooth with a dental implant. Patient reports they are concerned about the aesthetics and function of their smile. - No cosmetic concerns. - Patient reports brushing twice daily and flossing once daily. - Patient denies any habits such as clenching, grinding, or smoking. - No relevant family history of periodontal disease. - Patient had a root canal treatment on tooth #19 five years ago. Past Medical History: - No known medical conditions. - No medications. - NKDA. - Non-smoker. EXAMINATION: - Extraoral: No palpable lymph nodes. TMJ examination reveals no clicking or popping. Mouth opening is within normal limits. Smile line is high. - Soft tissues: Buccal mucosa, tongue, palate, floor of the mouth, and vestibule appear normal, NAD. - Dentition: Missing tooth #19. No crowding or spacing. Normal overbite and overjet. No fremitus. No dental caries. Restored teeth include amalgam fillings on teeth #18 and #20. No periapical problems. No pathologic migration. No impacted teeth. No supernumerary teeth. No attrition, abrasion, erosion, or abfraction. No mobility. - Oral Hygiene: Excellent plaque control. - Periodontal findings: Gingiva appears healthy, with no inflammation, normal colour, contour, size, and consistency. No recession, bleeding, or suppuration. - Pocketing depth range is 1-3mm. No localised or generalised pocketing. No calculus. No mobility. No furcation involvement. No overhangs. No CEPs. - Implant site: - Tooth #19 is missing. - Bone Assessment: Ridge width is adequate. Ridge height is adequate. Good quality bone at the proposed implant site. No resorption or defects. - Keratinized Tissue: 4mm of keratinized tissue at the implant site. No deficiencies. - Soft Tissue Biotype: Thick biotype. - Space: 8mm of mesial to distal space. 12mm of occlusal space. - Guidance: Not involved in guidance. - Other: No infection present. No inflammation present. Adjacent teeth are healthy. Radiographic Findings: - Cone Beam Computed Tomography (CBCT): CBCT shows adequate bone volume and density at the proposed implant site. The distance from the crest of the ridge to the inferior alveolar nerve is 15mm. The distance from the crest of the ridge to the maxillary sinus is 18mm. - Dental radiographs show no pathologies. Bone levels are normal. No comparisons with previous radiographs available. Intra-oral scan done with Trios Diagnoses: - Missing tooth #19. - Adequate bone volume for implant placement. Impression: - Prognosis: Excellent prognosis for implant success, considering patient-specific factors. - Good candidate for implant. - Implant can be placed with delayed natural healing. - No additional procedures are needed along with the implant. Discussion with patient: - Discussed the patient's missing tooth and the treatment options, including the benefits and risks of dental implants. Patient asked about the cost and the healing time. - Consent forms have been given for patient to take home and review. - The cost of treatment is £3,500. Treatment Plan: - Treatment Options: - Dental implant with a crown. The recommended option is a dental implant with a crown due to its long-term success and ability to restore function and aesthetics. Risks include infection, implant failure, and the need for bone grafting. - Surgical Plan: - The surgical approach will involve the placement of a Straumann implant, 4.1mm x 10mm, using a flapless technique. No bone grafting or sinus lift is required. - Osseointegration Test: Second stage surgery is required. Osseointegration test will be done in 3 months. - Prosthetic Plan: - The prosthetic plan involves a screw-retained porcelain crown. The timeline is approximately 4 months. A provisional prosthesis will be used. The restorative dentist is Dr. Smith. Materials and design considerations include the use of a custom abutment and a layered porcelain crown. - Supportive implant therapy: - Oral hygiene practices include brushing twice daily and flossing once daily. Annual follow-up visits. Hygienist recall interval is every 6 months.