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What Do The Following X-ray Reports Indicate?

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Posted on Fri, 11 Nov 2016
Question: Could you please review the attached xrays to determine if these teeth will need to be extracted.
What should the treatment plan be? Is there some bone loss?
What aggressive treatments are available?

Thank you
doctor
Answered by Dr. Honey Arora (39 minutes later)
Brief Answer:
Yes, bone loss present, details below..

Detailed Answer:
Hi..
Welcome to HEALTHCARE MAGIC..

I have gone through your query and can understand your concern...

I have evaluated your x-rays and it indicates severe bone loss with respect to lower front teeth..
It is almosthalf of the roots that bone is lost..

Along with it there is slight bone loss with respect to back teeth between second premolar and molar..

Before I can advise you treatment I would like to know a few more details..
1.Are you lower teeth loose?
2.Is there loosening of any other teeth also?
3.Is there any pain, bleeding or swelling of gums present?
4.As you visited the doctor what line of treatment is advised to you and what medication are given?
5.Is the cleaning of teeth done?
6.Do you have any medical problems or are you on any medications?

Please revert back with answers..

Regards..
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Honey Arora (2 hours later)
There are no teeth loose . Gum grafting has been done on the bottom teeth . The patient has also seen a periodontist. There is pain the gums are some points. There had been cleaning of the teeth done. What do you think is the most effective treatment? What aggressive treatments are available? Please help. The periodontist said the patient doesn't need bovine bone and when asked if she thinks the patient is going to lose the teeth she said no. Patient is requesting to take doxycycline . Do you think the patient is going to need dentures?
doctor
Answered by Dr. Honey Arora (31 minutes later)
Brief Answer:
Lower front teeth have considerable bone loss..

Detailed Answer:
Hi..
Welcome back..

As per your complain, the lower front teeth has considerable bone loss and the teeth are not moving as they are splinted with using wire at the lingual side
[towards the tongue]..

As gum grafting is already done you should wait and watch for the outcome of treatment..
Other treatment modalities that can be commonly done and are helpful are Gum and bone Regeneration Treatment..

Other areas are not having too much of bone loss and if you maintain a good hygiene you can maintain good gum and teeth health..

Doxycycline can be taken in case if there is infection in the gums and only after consulting your Periodontist..

As of now patient does not need dentures..

Hope this helps..

Regards..

Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Honey Arora (7 hours later)
Thank you for your answer.Can I please ask some more questions.

1. When you say Gum and bone Regeneration procedures - what do you mean? Does this include the following:
Bone Regeneration

Dental implants and other restorative procedures depend on the jawbone being sufficiently strong and thick. When periodontal disease has taken hold, the jawbone may have become too thin to successfully support an implant. Natural bone regeneration (or bone grafting) is one of the best ways to promote growth and thicken the jawbone.

Initially, bone grafting material is obtained from elsewhere on the body or from a bone bank. The gums are gently pulled back, and an opening is made in the jawbone where the grafting material will be packed in tightly. A membrane is used to maintain the shape of the new bone, and tissue stimulating proteins and a platelet-rich growth factor may be applied to promote faster healing. The surgical site will be sutured and packed with protective material. The bone will naturally regenerate and become strong enough to eventually support an implant.

Gum Tissue Regeneration

Gum tissue regeneration is usually performed by way of gum grafting. When gum tissue has been lost as a result of periodontal disease, the smile may appear discolored, toothy or unpleasant. A gum graft aims to symmetrically contour the gum line, cover any exposed tooth roots and restore health to the gums. Initially, a small strip of tissue will be removed from the roof of the mouth and placed in the middle of a split-thickness incision at the recipient site. The surgical site will be covered with a protective membrane which promotes tissue regeneration, covered in platelet-rich growth factor and tissue stimulating proteins, and then sutured closed. The soft tissue surrounding the teeth will naturally regenerate, producing a healthy, smile.


2. What acan be done if the patient has Jaw recession? The pt had braces and corrective hjaw surgery 5 years ago . Is there a way for the Dentist / oral surgeon / periodontist to determine if the jaw has receeded?

3. Would another splint be beneficial at this time? Also, the pt may want to correct his bite further - can the pt undergo orthodontic treatment and another corrective bite surgery or is it not recommended with his current periodontal disease? I read the correction of the bite may be beneficial to treat addional periodontal disease - is that true?

4. What is the cause of the upper part of the tooth right before the gum to be getting smaller is this from teeth deterioration? if so, can the bone/tooth deterioration be fixed? if so, how?

5. What are the chances of this pt keeping his teeth attached in his mouth to his own jaw for the next 30 years without needing teeth implants / dentures?

Thanks so much

Yes I have noticed that some of the teeth are loose

What can I do ? Is there anyway to save them?


doctor
Answered by Dr. Honey Arora (15 hours later)
Brief Answer:
Detailed below..

Detailed Answer:
Hi..
Welcome back..

As per your query Regeneration treatment involves both bone and gum tissue regeneration..

Secondly there is excessive bone loss inower front teeth so first of all you need to go for getting it treated and no corrective surgery or splint is to be done as of now..

It is not jaw recession but gum recession and bone loss..
It can be evaluated by clinical evaluation and x ray..

The crown portion of tooth getting smaller can be due to attention of teeth that occurs due to wearing of tooth structure caused by aging process..

They can be corrected by capping or do I g but presently you need to get the regeneration treatment first..

After a certain amont of bone loss occurs then regeneration can also become difficult, also at times complete regeneration is not possible..

So you will have to get the treatment done followed by regular follow up and then only what exact improvement occurs can be judged will be ruled out and the further prognosis can be explained..

Maintain a good Oral hygiene to prevent further infection and damage..

Any further questions are welcome..

Regards..


Above answer was peer-reviewed by : Dr. Veerisetty Shyamkumar
doctor
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Follow up: Dr. Honey Arora (28 minutes later)
ok
If some of the teeth are slightly loose (one moves slightly back and forth) does that mean that the gum must be extracted? I am very devastated. The periodontist said she thinks "the teeth will not need to be extracted". Is there any chance that the tooth will stopt being loose without any urgent treatment just exercise, good diet?
The other dentist said we could make you a splint? And when we asked one dentist if going to lose the teeth he said "are you kidding? no."

Should I rush to another periodontist to get bone regeneration and gum regenation?

thank you
doctor
Answered by Dr. Honey Arora (3 minutes later)
Brief Answer:
Detailed below..

Detailed Answer:
Hi..
Welcome back..

If tooth is slightly loose then you will not loose it immediately and in case if you maintain a good Oral hygiene, get regular scalings done then the chances of further damage goes less.

But for lower front teeth the damage to bone is considerable and for this treatment should be done soon..

Hope this helps..

Regards..
Note: Find out which dental treatment will work best for your teeth. Ask here.

Above answer was peer-reviewed by : Dr. Veerisetty Shyamkumar
doctor
Answered by
Dr.
Dr. Honey Arora

Dentist

Practicing since :2011

Answered : 14092 Questions

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What Do The Following X-ray Reports Indicate?

Brief Answer: Yes, bone loss present, details below.. Detailed Answer: Hi.. Welcome to HEALTHCARE MAGIC.. I have gone through your query and can understand your concern... I have evaluated your x-rays and it indicates severe bone loss with respect to lower front teeth.. It is almosthalf of the roots that bone is lost.. Along with it there is slight bone loss with respect to back teeth between second premolar and molar.. Before I can advise you treatment I would like to know a few more details.. 1.Are you lower teeth loose? 2.Is there loosening of any other teeth also? 3.Is there any pain, bleeding or swelling of gums present? 4.As you visited the doctor what line of treatment is advised to you and what medication are given? 5.Is the cleaning of teeth done? 6.Do you have any medical problems or are you on any medications? Please revert back with answers.. Regards..