Dental implant placement in place of tooth #18

November 28, 2008 9:45 pm Published by

42 year old female presented for an implant placement in the space of tooth #18. Previously it was noted that the patient was having periodontal problems, had undergone several rounds of scaling and root planning and had been placed on amoxicillin with metronidozole to resolve the condition. A periodontal culture was taken to determine the type of pathogens and if any resistant strains were present. The lab results showed gram negative rods resistant to both of the antibiotics. The patient was placed on 500 mg Cipro BID 7 days. A follow up visit revealed the gums were in a better condition. The patient was also referred to Dr. Keith Berkowitz ( to test for fasting blood sugar levels due to the suspicion of a systemic cause of the periodontal condition, prior to implant placement. The blood test revealed a fasting blood sugar level of 139 and the patient was diagnosed with diabetes.  Dr. Berkowitz recommended controlling the diabetes with diet modification for this health-oriented, compliant patient.

Today, the patient was anesthetized and given proper surgical dressing. A flap was made from teeth 20 to18. A 6 x 9 mm implant was placed, as well as a 5.7 x 3mm healing abutment was placed out of occlusion. Slight enamelplasty was done on tooth 18 to allow room for the healing abutment, due to the severe mesial angulation of tooth 18. A panoramic film was taken to verify proper placement of the implant as well as proper seating of the healing implant. The tooth was left without a temporary for the time being to allow integration of the implant and bone.

N.D., New York University College of Dentistry

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