LOS ANGELES PERIODONTIST CASE STUDIES
CASE STUDY
Multiple Dental Implants
This was a very special case we had the opportunity to work on. This patient was missing his two lateral incisors since birth. Instead of seeking the dental work needed, he wore two removal plastic teeth to hide his missing teeth for over 20 years! He was too scared to visit the dentist because of a previous traumatic experience and instead lived in fear and discomfort for twenty years.
He trusted us to restore his smile and with thorough communication and several visits, he left confident with his results, and achieved his dream smile!
After a proper diagnosis, Dr. Aalam determined that multiple dental implants would be the best solution for improving this patient’s smile. Dental implants are the optimal solution because they are a permanent way to restore a beautiful, natural looking smile. During the initial consultation, Dr. Aalam found that this patient experienced minor bone loss, as well as gum recession over the right canine. Dr. Aalam communicated the diagnosis thoroughly and created a personalized treatment plan for this patient.
First, a bone and tissue graft needed to be done in order to prepare the mouth for permanent dental implants. Permanent dental implants are placed directly in the jaw bone, and replace the tooth roots. If a patient lacks the adequate bone density needed to sustain multiple dental implants, a bone graft must be completed in order to create a foundation for the implants. Bone grafting is the process of restoring the lost or damaged bone in the jaw, often caused by untreated periodontal disease.
If you are missing teeth and are in need of dental implants, a key factor in the dental implant procedure is having enough bone in the jaw to support the implants. Patients who lack the bone density needed to sustain single or multiple implants may be in need of a bone graft.
There are different types of bone grafts that utilize bone taken from various sources, such as the patient’s own bone taken from a different part of their body, or bone sourced from a bone a bank. The bone is sterilized and prepared to create the grafting material, which is then applied to the area in need.
When patients come in with extreme forms of tooth and bone loss, it is important to understand the cause in order to determine the best treatment for each patient’s needs! Many patients are told they are not a candidate for permanent dental implants because they suffer from bone loss, but this couldn’t be farther from the truth! Thanks to advanced technology and graftless implant treatments, we are able to transform our patients’ smiles with permanent dental implants even if they lack the bone density in their jaw needed to place an implant.
In this case, Dr. Aalam first performed a bone graft to strengthen the supporting bone and restore the adequate density needed to anchor the permanent dental implants. Next, under IV sedation, a tissue graft was also performed to treat the gum recession above the right canine. Tissue from the patient’s mouth was taken and grafted to the gum to restore the lost tissue, create an even gum line, and protect the tooth roots. When patients experience gum recession, the exposed underlying bone puts them at a greater risk for developing disease and decay, in addition to causing sensitivity to hot and cold foods. By creating a healthy, even gumline, we also restored this patient’s ability to eat with comfort and ease.
Next, utilizing advanced technology, a scan of the patient’s mouth was complete, and we created a mold to determine exactly how the implants would be placed and what the results would entail. The gum and bone were allowed time to heal, and during the patient’s next visit, he received his permanent dental implants. The implants were anchored securely into the bone, and completed with temporary restorations so the patient would have what appears to be a complete smile, while the tissue around the implants healed, and the Osseointegration process occurred. This is the process which allows for the implants posts to naturally fuse to the jawbone.
After four months, the patient returned to our office, the temporary restorations were removed, and permanent ceramic implants were placed that blended seamlessly with the patient’s smile!
Each patient we see comes in with a unique set of needs, and we work to ensure they receive proper diagnosis, excellent care and a treatment plan that accommodates their lifestyle. This patient is a high profile figure, who spends the majority of his time in front of the public eye. As a result, he cannot ever be seen without a complete smile, or undergo procedures with extended healing times.
Thanks to advanced technology coupled with a correct diagnosis and expert care, we were able to change his life with the All-On-4 dental implant treatment! By giving him the ability to do the simplest things many take for granted like eating and chewing with ease and comfort, and smiling confidently, we helped restore a sense of normalcy in his life. It is our greatest privilege to help our patients love their smiles, and we are grateful to be trusted to treat their periodontal needs.
After a careful diagnosis, Dr. Aalam determined this patient suffered from periodontal disease, which left his teeth and gums inflamed, decayed and seriously infected. As with any case, thorough diagnosis is required to ensure each patient is receiving sensible care for their unique case, with the goal of restoring optimal oral health. Without quickly jumping to extreme forms of treatment, and after a proper evaluation Dr. Aalam concurred that the patient’s lower teeth could be treated with periodontal therapy, a deep cleaning treatment to restore his oral health, allow the patient to actually keep his own teeth. However, the top teeth were severely affected by periodontal disease, and extraction was necessary. As a result, Dr. Aalam determined that the All-On-X treatment would be the best solution for replacing this patient’s upper teeth.
Dr. Aalam was trained in Portugal by Dr. Paolo Malo, the founder of the All-On-4 technique, and has been performing the procedure for over a decade. His expertise, commitment to excellence and experience allows him to diagnose patients and create the best course of treatment for their specific needs.
All-On-X is the ideal solution for restoring all of your missing or damaged teeth using a minimum of four dental implants. With the cutting-edge treatment, patients transform their smile with a full set of upper or lower teeth in just one day! This unique treatment is a graftless procedure that utilizes the patients’ existing bone to avoid the need for a bone graft, making it a more comfortable and less invasive procedure than traditional implants. Often times, patients who experience bone loss are told they are not a candidate for dental implants, and are stuck having to use dental flippers, dentures or other uncomfortable, non-permanent tooth replacements. With innovative treatments like the All-On-X, a skilled periodontist can now replace patients’ missing teeth, by utilizing their existing bone density. In this patients case, four implants were placed in the upper jaw, two straight and two tilted, and an immediate temporary prosthesis was placed. Dr. Reshad of Art Lab Dentistry created the final zirconia reconstruction and once the tissue healed, the final restorations were placed!
CASE STUDY PERIODONTAL DISEASE
When left untreated, periodontal disease can progress to extreme cases of periodontitis, which causes the teeth and gums to decay and completely fall out. This patient came in with an advanced case of periodontitis, where the gums were so inflamed, his top teeth completely fell out. As evident in the picture, he also experienced extreme decay in the bottom teeth as well. Not only was this patient in need of a complete smile transformation, he needed the restore his oral health. Periodontal disease can cause a number of health complications, and if left untreated not only affects one’s smile, but also overall health. Did you know periodontal disease can affect the heart and respiratory health, brain health and cause pregnancy complications? It is imperative to treat periodontal disease at the onset when it begins with gingivitis, a mild inflammation, to avoid detrimental health effects down the line.
After a thorough diagnosis, Dr. Aalam determined this patient would need to have his bottom teeth completely removed, and multiple dental implants would be placed in both in the upper and lower jaw to restore this patient’s smile.
In his first appointment, the infected lower teeth were removed, and five permanent dental implants were immediately placed in the upper jaw. Dental implants are the ideal solution to replacing damaged, missing or extracted teeth, because they integrate into the jawbone to become a permanent part of your mouth, so they cannot slip, break or cause damage like dentures or a fixed bridge can. Patients can opt for titanium or zirconia implants, also known as a holistic alternative to metal implants, which will permanently replace the tooth roots. Because dental implants are rooted in the jaw bone, it is imperative that the patient possesses adequate bone density to support the implants. If the patient experiences bone loss, a bone graft may be done prior to, or together with the dental implant placement. In this patient’s case, his jaw bone was healthy and Dr. Aalam could proceed with placing the dental implants, without needing to perform any additional procedures. The permanent dental implants will serve as the foundation for the new, permanent restorations also known as fake teeth, that look, feel, and function just like real teeth!
Once the implants are placed, we create a temporary set of teeth so that the patient leaves with what looks like a complete set of teeth, to avoid any embarrassment as well as discomfort when chewing and speaking, during the healing process. In this patient’s case, we worked with Dr. Stephanie Young, who provided a fixed temporary prosthesis on the day of the procedure.
After three months, the tissue around the implants completely healed, and the Osseointegration process was complete. This is the process where the permanent dental implants naturally fuse to the jaw bone, allowing the new implants to permanently serve as the ‘tooth roots.’ A final full arch zirconia reconstruction was secured to the lower jaw to replace the teeth that were removed. In this case, we placed an overdenture, a particular type of dental prosthesis, on the upper jaw, to complete this patient’s smile, and restore his oral health!
CASE STUDY Crown Lengthening Procedure
We had a unique opportunity to correct a faulty dental job performed by a different provider. We strive to ensure each patient receives excellence in care, personalized plans to treat their particular cases, and life-changing results. Although this becomes challenging when we’re correcting damage sustained by a different provider while also treating the initial problem, we successfully rejuvenated this patient’s smile and restored his confidence!
This patient came in with gum tissue inflammation as a result of inadequate tissue handling in the case of an incorrect crown lengthening procedure. The treatment was initially done to correct his gummy smile because he experienced excessive gum tissue that covered his teeth and an uneven gum line. He opted to treat the gummy smile, but an incorrect diagnosis led to an incorrect treatment. As a result, his gum line remained uneven, and his tissue became damaged.
In other cases, due to the natural movement and position of the lips, some patients experience a gummy smile when smiling or speaking, because the lip naturally draws up higher, exposing more of the gums and creating what appears to be a “gummy smile”.
A gummy smile can have serious effects on one’s confidence, and affect the beauty of your smile. A healthy, dazzling smile begins with healthy gums. Gums should lay evenly along the crowns of the teeth, without covering the teeth excessively. For those who suffer from gummy smiles as a result of excessive gum tissue, crown lengthening is one procedure that can be performed to treat a gummy smile.
Upon closer examination, Dr. Aalam diagnosed the patient with having excessive gum tissue, as well as underlying bone, both which needed to be removed. First Dr. Aalam performed osseous surgery, to remove the excess and damaged bone this patient sustained after receiving faulty dental care from a previous provider. Osseous surgery is the process in which your periodontist will remove and/or recontour the damaged bone around the tooth in order to remove the bacteria that are causing inflammation of the gums, remove the pockets created as a result of the bacteria spreading, and smoothing out the bone to create a clean, healthy slate so that the gum tissue can be reattached to the bone. Dr. Aalam then removed the excess gum tissue, and realigned the gums at the proper junction to create a healthy, even gum line that exposed the correct amount of tooth. By removing the extra tissue that was covering the teeth, and evening the underlying bone, he was able to expose a brighter, more aesthetically pleasing smile. As a result, Dr. Aalam successfully re–established gingival and smile harmony, and provided this patient with a broader, more beautiful smile!
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