An 18-year-old female presented with tooth No. 7 missing after a history of trauma. At age 7, she fell and the tooth avulsed. It wasn’t stored in any “liquid” or ideal environment, and when it was reimplanted, the results were compromised. No endodontic treatment was performed and at age 16, the patient lost the tooth; a temporary was fabricated. Subsequently, she had a bone graft using DynaBlast DBM Paste (Keystone Dental) plus a membrane barrier placed after decortification of the site; another temporary was placed. The patient again lost her temporary, and it was rebonded with resin composite at another clinic.
A 46-year-old male presented to my practice with this chief complaint: “My teeth are getting smaller.” After a comprehensive exam, I determined that a lifetime of bruxing had caused significant wear. Over time, he had lost his anterior guidance, including his canine guidance.
The patient received facial trauma at age 14 when she was hit by a golf club in the maxillary pre-molar region. In 1998 the patient lost several maxillary teeth due to external root resorption. During that time a PFM Nobel Bridge was placed using metal linguals on teeth Nos. 8 and 9 and a metal occlusal on No. 14. In 2011, the patient fractured the porcelain off No. 8 and desired a more cosmetic material to replace the entire bridge.
A middle-aged female in good health presented with tooth No. 9 positioned lingually and inferiorly to teeth Nos. 8 and 10 with tight proximal contacts. The position of tooth No. 9, which was caused by trauma, prevented the patient from closing her mouth normally. She also had pain and sensitivity involving this tooth.