Patient Prilenskaya T.A. aged 60
Patient Prilenskaya T.A. aged 60, film director (the name and photos are published by the patient’s consent).
Applied to NANO-DENT in February, 2013. Before that the patient consulted on account of exacerbation of chronic granulomatous periodontitis of teeth 22 and 23 (upper left incisor and canine). Case history revealed that several years ago teeth 22 and 23 were endodontically treated before placement of metal and ceramic denture. However in half a year the patient began to feel a slight pain above roots 22 and 23 accompanied by recurrent swelling along the transient fold in this area. The patient’s general condition also became worse. The patient applied to a number of dental clinics in Moscow, where after OPG and spot roentgenography of 22 and 23 the case was diagnosed as chronic granulomatous periodontitis with periodontal cysts. It was recommended to remove the existing denture, to extract teeth 22 and 23 and to place a new denture. The patient rejected the offered treatment and applied to NANO-DENT in February, 2013.
Here the examination showed the following: Body temperature 37.2° C. Slight asymmetry of face due to soft tissues edema in the left suborbital area and in the left part of upper lip. The left nasolabial fold is smoothed. Palpation along the left wing of nostril is painful.
In oral cavity: Transient fold above 22 and 23 is hyperemic, infiltrated and painful when palpated. Fluctuation. Percussion of metal ceramic crowns 22 and 23 is sharply painful.
OPG 1. Patient P.aged 60. The bone pattern is predominantly large-looped. In both parts of the upper jaw the bone is thin in the areas of adentia. Light foci in the bone structure of different size and localization. The solid metal ceramic denture is fixed on teeth 15, 13, 12, 11, 21, 22, 23 with two consoles one at the left and one at the right. Partial adentia in the upper jaw. Above roots 22 and 23 there are light zones, each approximately 1cm in diameter.
Spot X-ray photograph. Wide light zone along the full length of root 23 turning into the focus of local osteoporosis above root 23. Deep wedge-shaped light zones between roots 21 and 22, 22 and 23.
Computer tomography of the upper jaw: Foci of osreoporosis (underlined), missing bone in front of root 13. Hyperplastic maxillary sinusitis at the left and right sides.
Diagnosis: Acute purulent periostitis of the left upper jaw from 22 and 23. Exacerbation of chronic granulomatous periodontitis of 22 and 23. Suppurated periodontal cysts of 22 and 23. Medium-degree parodontitis in the areas 21, 22 and 23. Parodontosis.
Treatment scheme: Incision along the transient fold above 22 and 23, drainage, antibiotics, antiphlogastics, antihistaminics. Soda-salt-iodine oral bathes up to 20 a day. Further on: conservative therapy to eliminate local osteoporosis (cysts) above and near roots 22 and 23, restoration of the bone in front and at the right of root 23, treatment of parodontitis. It was decided to carry on treatment without removal of the metal ceramic denture.
Treatment: At first the acute purulent periostitis was cured. The next step included cauterizing of cysts above roots 22 and 23 with the subsequent injection of NHAG (nanostructured hydroxyapatite gel) enriched with nanosilver (collargol) into cyst cavities through root canals. The procedure was carried out several times through crowns and root canals 22, 23. The treatment was basically completed by the end of May. The patient was taken under dynamic supervision.
The foci of local osteoporosis are eliminated. The neogenic bone has integrated into the organotype. The bone pattern is fine-celullar.
The spot X-ray photograph shows that the neogenic bone around root 23 has higher density as compared with the surrounding organotype.
Photo of the metal ceramic denture in July, 2013.
Photo of the patient in July, 2013.