A patient visited Dr. Whitman at Leesburg Family & Cosmetic Dentistry a few years ago when he fractured his upper right premolar. Unfortunately, the tooth wasn’t able to be saved due to the nature of the fracture.
Dr. Whitman extracted the tooth and grafted the site with bone and then a membrane to prepare for a dental implant to replace the missing tooth. However, some time went by, and during this period, the patient, who had had orthodontic treatment as a teenager, wasn’t wearing his retainers at night to keep his teeth straight.
As a result of not wearing his retainers, his teeth began to shift. The space where the extracted tooth had been—originally left open for a dental implant—became too narrow to accommodate an implant or the crown on the end of the implant to look like a natural tooth. Because the teeth on the side of the extracted tooth shifted, the premolar that was still present leaned too far into the open space for a successful dental implant procedure.
Also during this time period, the patient lost his upper left molar, which caused the teeth to shift further. As a result of all the shifting, he developed crowding of his upper front teeth, which caused his lower front teeth to bite into his upper teeth, rather than having a comfortable overlap of the teeth. As a result of this, the patient’s upper front teeth became extensively chipped on the edges.
The patient was a candidate for Invisalign, and began treatment to begin to restore the shifting that had impacted his smile. After a year and a half of treatment, his teeth were realigned with a healthy bite where the patient was no longer chipping his front teeth. Enough space had opened back up to allow for a dental implant placement on both the upper left and upper right side of his smile.
One implant has been placed, and later this year, he will have the remaining one placed. Once the implants have integrated with the surrounding jaw bone, we can place beautiful implant crowns which are the right size and contour for the spaces. Of course, the patient is now diligent about wearing his retainers every night to keep his smile from shifting again.