Developmental Problems And Implants



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Dr. Richard Shanaman, P.C. : Developmental Problems And Implants

Dr. Richard H. Shanaman, P.C.
1719 Penn Ave
Wyomissing Hills
Reading, PA 19609
info@drshanaman.com
(610) 678-4531

Deciduous (Baby) Teeth
Case 1

Sometimes as we go from our deciduous dentition (baby teeth) to our permanent teeth, a tooth may not develop. Prior to implants, attempts were made to solve this problem by orthodontically moving the canine (eye tooth) forward. This fills the space in front of the mouth; but the tooth is often too large to be esthetically pleasing.

In an approach to solve this problem without cutting down adjacent teeth for a fixed bridge, a Maryland bridge can be constructed. The major drawback of this attempt is that often the bond to adjacent teeth breaks and the replacement tooth is lost. Implants and our ability to regenerate new bone solve this dilemma.

Incisor Implant and Veneer
Case 2

The congenitally missing right lateral incisor was replaced with an implant, and a crown was placed on it. The implant crown appears to emerge naturally from the gum. The space around the left lateral incisor was closed with a veneer.

Regeneration and Implant

Case 3

This patient had bilateral congenitally missing lateral incisors. Bone regeneration was required to establish normal contours and sufficient bone for implant placement. Fortunately, it was possible to implant and regenerate at the same time.

Deciduous Tooth (Baby Tooth)

Case 4

It is not uncommon when permanent teeth begin to erupt that one or more of them do not do so. This most commonly happens with the canines (eye teeth). The treatment is usually uncomplicated - just extract the deciduous tooth (baby tooth), and surgically expose the crown of the impacted tooth so an orthodontic chain can be bonded to it. The tooth can then be moved into proper position orthodontically.

In this case, the canine (eye tooth) was impacted, and then brought into position with orthodontics. Unfortunately, there was periodontal disease present, which was not recognized or treated. As a result, bone did not come down with the tooth as it was moved into position. This resulted in a severe bony defect (see X-ray).

The two involved teeth were extracted and a bone graft placed. After healing, the ridge appeared very irregular and required a soft tissue graft.

In the final photo, the implants are restored. Note the healthy pink color of the gums.