Topic

[Prosthetics]  Irritated Gingiva


The history of the 16 was SCRC that was 3 years old.

The patient has always sort of complained about the area feeling irritated.

On one occasion there was a parulis on the mid buccal on the free gingiva.

I did remove the crown and place a healing cap and had a new crown fabricated by EVO CAD as I thought the emergence was 

poor. I believe the patient felt relief with the healing abutment in place and the parulis was gone.

Fast forward to today and the radiographs and photographs are of the new crown.

Chief complaint is still gingival irrigation and now the palatal seems to be the issue.

Occlusion is good, contacts are not too tight and it does not appear that there is any parafunction.

What is my best course of action in this case?


Dr. Chad Denomme


by Chad Denomme at Thu, Oct 19, 2017 7:28 AM

1767 Views | 5 Replies

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Chad Denomme Replied at Mon, Oct 23, 2017 7:27 AM

So Bernard what would you advise.


I am thinking to remove the SCRC and place healing abutment.


Where do I go from there to evaluate if its fixture abutment or just fixture.


If it is fixture level should I lay a flap and IBRUSH.


Chad



Likes : 1

Bernard Jin Replied at Thu, Oct 19, 2017 3:17 PM

In dentition - a palatal 'sinus tract' usually indicates a root fracture (a small space that harbours bacteria). Unsure that would 'obviously' mean around an implant fixture.




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Bernard Jin Replied at Thu, Oct 19, 2017 3:16 PM

Hi Chad,

thanks for posting the case.  

I believe you mentioned that the parulis resolved once you switched the restoration abutment for the healing abutment.  How long did you leave the healing abutment on?  Was it resolved completely?

What did you do to verify that there was no more infection?

Reason for asking:  if infection resolves - then likely problem was interface between abutment + fixture.  if it doesn't resolve, then problem persists with fixture.




Likes : 1

Bernard Jin Replied at Thu, Oct 19, 2017 3:15 PM

Hi Chad,

thanks for posting the case.  

I believe you mentioned that the parulis resolved once you switched the restoration abutment for the healing abutment.  How long did you leave the healing abutment on?  Was it resolved completely?

What did you do to verify that there was no more infection?

Reason for asking:  if infection resolves - then likely problem was interface between abutment + fixture.  if it doesn't resolve, then problem persists with fixture.




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Bernard Jin Replied at Thu, Oct 19, 2017 3:07 PM