Receding gums and replacement teeth

Periodontal disease results in gum and bone loss around teeth. When the bone and gum loss is advanced, this can lead to teeth becoming loose and requiring removal. However, what if it was possible to replace the missing gums around teeth before they became loose? Before it was too late?

In this case our patient presented with periodontal disease affecting many of her upper anterior teeth (incisors and canines). The gum and bone loss around the 4 incisors was advanced and had resulted in tooth mobility. These 4 teeth were clinically indicated for removal which is why we planned to replace them with dental implants. The UL3 canine tooth also had severe recession of the gums however, the bone levels were still good enough for the tooth not to be loose. We did not want to leave this tooth as it was, because receded gums are generally very thin and more vulnerable to further recession. It is sometimes like a negative feedback loop with more recession resulting in even more recession. We wanted to maximise the longevity of the canine whilst replacing the incisors.

The upper incisors were replaced using 2 dental implants and 4 unit implant supported bridge – the standard protocol when replacing anterior missing teeth. We also rebuilt the bone structure at the same time as implant surgery. During the same procedure, we provided the patient with a gum graft to transplant connective tissue in the region of the UL3 canine. This enabled us to coronally advance the gum line back to normal levels. It is almost like reversing 10 years of recession within one procedure.

The treatment provided to this patient has not only replaced her failing incisors with aesthetic and functional implant supported teeth but, we have also improved the lifespan and appearance of her exisitng canine tooth as well. This is a good example of how we can save teeth and replace teeth at the same time to provide our patients with the best combination of treatments.

Thank you for reading,

Mohsin Patel