This case study portrays a complex periodontal involved patient with two implants. Mrs. B is a middle-aged Asian woman who has not had a cleaning for 18 months. Her chief complaint was that she senses sensitivity and there was bleeding upon brushing her teeth. Mrs. B was not on any medication, but her blood pressure was slightly elevated to pre-hypertensive levels. Extraoral and Intraoral findings were all within normal limits.
Mrs. B had many previous restorations done. Numerous composite restorations were detected, PFM crowns were placed on all mandibular molars, and there were two implants on the maxillary first molars. This patient also had many deep pockets, the probing depths ranged from 3mm to 8mm with a localized recession on the linguals of anterior mandibular teeth. The gingiva was red in color, inflamed, moderate to heavy bleeding upon probing, spongy, bulbous interproximally, and festooned. Radiographic findings demonstrated a generalized 20% horizontal and vertical bone loss.
Treatment planning for this patient required more consideration; calculus detection classified her as a heavy patient, and from assessments, I determined pain management would be necessary. As a result, I separated the treatment into three visits. Local anesthesia PSA and MSA were administered on both quadrants I and II, and for the mandibular quadrants, I used Oraqix.
Overall, this patient was one of the more challenging cases I accomplished due to the many variables present. Thankfully, the patient was very satisfied with the treatment and was happy that I spent so much time and cared about her oral health.
