Patient presented with missing lower 4 front teeth, scientifically numbered as 31,32, and 41 and 42. 3 being lower left quadrant and 4 representing lower right quadrant. There 8 teeth per quadrant and there are in all 4 quadrants. 1 represents upper right and 2 the upper left quadrant. Hence the first number in a notation is quadrant number while next number is the tooth number-beginning midline.
Other teeth missing were 37 and 38, 15 and 17.
Apart from that severe mobility seen in 33, 43(calculus hindering the mobility), 24, 25 and 28 27 and 26.26 and 27 grossly carious and exposed with root caries.They may need to be extracted and replaced at various stages, some early and some later, depending upon what we achieve on time line. X â€“rays also show 4-6mm of bone loss at almost all the places.
Work done till now 26, 27 removed and bone placed along with 2 implants.
2. RCT Begun in 46.
- Cranio-Sacral Rehabilitation involves doing 32 caps, along with correction of Yaw pitch and roll. Work time 250-300 hours.
- Onlay Bone graft in lower front segment, upper back side right side segment, and lower left back segment. time 1 day
- Wait for 4 months, and then place implants at missing teeth segments â€“ approximately 10-13 31,32,33,41,42,43, 15, 17, 18(normal dentist wonâ€™t agree to this, but latest evidence by master researcher Dr. Dave in favor of it), 37,38.
- Wait for 5.5 months and load the implants.
- Place the caps on implants,.
- Wait for 6 months, and get bone graft surgery done on teeth, from a doctor from Bombay. Total quadrants =4..
Caution: Any procedure has 2-5 percent failure rate. Implants in her may have 5-10percent failure rate. Only implants replacement costs and caps replacement cost is covered for 8/10 years respectively. 13,23,33,43 will need replacement normally at 6 years.
This treatment is not a panacea, but patient will need some extra care from time to time. The intention is to slow down the breakdown loss substantially.