hannah1In my previous article, I introduced an 8-year-old female patient that sustained fractures to #8 and #9 after falling from her bicycle. In this article, I will go over her five year follow up, as well as her nine year follow up.

The patient returned for a routine follow up in November of 2010, complaining that her gingivae were tender in the edentulous site. With the remodeling that had occurred in the area, the coronal part of the remaining root tips were now poking through the soft tissue. (Fig. 1)

The area was anesthetized and the tooth structure was simply beveled to the crest of bone. The attached gingiva granulated in to form a wide band of keratinized tissue. The patient has had several iterations of removable partial dentures as she has undergone orthodontic treatment and matured.

She presented in early May of 2014, for a nine year follow up at age seventeen. Since she is about to enter her senior year in high school, she's interested in the more esthetic and fixed solution for replacement of her central incisors. (Fig. 2)hannah2

This is what we have been waiting for since we began treatment in 2005. Should I place implants now? (Fig. 3-4)

hannah3The best evidence available is that implants can be placed without fear of continued facial growth and development after age twenty. The patient is currently 17.5 years of age and states that "she has not grown since the 8th grade." The only way to confirm that this is true and proceed without fear of a permanent esthetic disfigurement, is to have at least two serial lateral cephalograms taken about 12 months apart that show NO change in growth of the maxilla. The patient has been referred to the orthodontist.

Stay tuned for the outcome…

Glen E. Doyon, DMD, Spear Contributing Author [ www.CMSEndo.com ]