![16-final-crowns-smile Patient after two dental implants and final crowns.](https://portlandperioimplantcenter.com/wp-content/uploads/2019/12/16-final-crowns-smile.jpg)
Advanced Periodontal Disease
Periodontal disease is the leading cause of tooth loss. According to the Center for Disease Control (CDC) nearly half of all adults age 30 and above have some form of periodontal disease and that increases to seventy percent of adults age 65 and older. In most cases, progression of the common gingivitis to more destructive periodontal disease (or advanced periodontal disease) may be prevented. Periodontal disease causes loss of bone and tissue around teeth. Although treatment modalities exist to arrest and often reverse the destructive effects of the disease, in its most severe form extraction of the involved teeth may remain the only option.
Todd was referred to the Portland Perio Implant Center for evaluation and management of his periodontal disease. A thorough clinical and radiographic examination revealed generalized disease distribution. All areas, with the exception of the upper anterior teeth, were successfully treated with non-surgical therapy. The upper anterior incisors however, exhibited extensive bone destruction, severe inflammation, extrusion, and mobility. They were deemed as non-salvageable and planned for extraction.
![PPIc-icon Portland Perio Implant Center](https://portlandperioimplantcenter.com/wp-content/uploads/2018/06/PPIc-icon.png)
"Loss of teeth, especially in the smile zone, can be devastating with psychological and social impacts on the patient."
DR. KAMRAN HAGHIGHAT, B.D.S., M.S., P.C.
![1-Todd-before View of front teeth with advanced periodontal disease.](https://portlandperioimplantcenter.com/wp-content/uploads/2019/12/1-Todd-before.jpg)
![2-after-extraction After extraction of two front teeth.](https://portlandperioimplantcenter.com/wp-content/uploads/2019/12/2-after-extraction.jpg)
![3-xray-showing-bone-loss Xray showing bone loss in the two front teeth.](https://portlandperioimplantcenter.com/wp-content/uploads/2019/12/3-xray-showing-bone-loss.jpg)
![4-extracted-teeth Extracted teeth of patient.](https://portlandperioimplantcenter.com/wp-content/uploads/2019/12/4-extracted-teeth.jpg)
![5-healed-tissue Healed tissue after extraction of two front teeth.](https://portlandperioimplantcenter.com/wp-content/uploads/2019/12/5-healed-tissue.jpg)
![6-removable-appliance Removable appliance for two front extracted front teeth.](https://portlandperioimplantcenter.com/wp-content/uploads/2019/12/6-removable-appliance.jpg)
Loss of teeth, especially in the smile zone, can be devastating with psychological and social impacts on the patient. Severe loss of bone and tissue causes large defects after the teeth are removed. Meticulous regenerative procedures to reconstruct the lost tissues will be required. Larger defects may need multiple procedures to achieve an acceptable esthetic result. Patients must be informed with respect to the length of the treatment as well as having a realistic expectation of the final outcome of therapy.
![7-xray-temporary-crowns Xray of temporary crowns.](https://portlandperioimplantcenter.com/wp-content/uploads/2019/12/7-xray-temporary-crowns.jpg)
![8-temporary-crowns Temporary crowns in patient's mouth.](https://portlandperioimplantcenter.com/wp-content/uploads/2019/12/8-temporary-crowns.jpg)
![9-implants View of dental implants after surgery](https://portlandperioimplantcenter.com/wp-content/uploads/2019/12/9-implants.jpg)
![10-intraoral-scan Intraoral scan digital workflow](https://portlandperioimplantcenter.com/wp-content/uploads/2019/12/10-intraoral-scan.jpg)
![11-work-flow View of dental implant workflow](https://portlandperioimplantcenter.com/wp-content/uploads/2019/12/11-work-flow.jpg)
![12-work-flow View of fitting for final crowns.](https://portlandperioimplantcenter.com/wp-content/uploads/2019/12/12-work-flow.jpg)
Following the removal of the upper anterior incisors, a removable appliance was provided and a healing period of two months allowed for soft tissue healing. Bone and soft tissue grafting was performed and after a 5 month healing period, two dental implants were placed. Temporization of the implants after three months were done to sculpt the soft tissues. Final impressions were made using an intra-oral scanner (Trios 3Shape). The implants were restored with custom screw-retained zirconia and porcelain crowns.
Although in such cases patients must endure a long journey with multiple procedures for regaining a confident smile back, we strive to make that journey worthwhile.
Final Crowns
![13-final-crowns-fitting Final crowns before installation to patient.](https://portlandperioimplantcenter.com/wp-content/uploads/2019/12/13-final-crowns-fitting.jpg)
![14-xray-final-crowns Xray of final crowns.](https://portlandperioimplantcenter.com/wp-content/uploads/2019/12/14-xray-final-crowns.jpg)
![15-Final-crowns Final crowns](https://portlandperioimplantcenter.com/wp-content/uploads/2019/12/15-Final-crowns.jpg)
![PPIc-icon Portland Perio Implant Center](https://portlandperioimplantcenter.com/wp-content/uploads/2018/06/PPIc-icon.png)
In Todd's own words:
“I have found the Portland Perio Implant Center to be exemplary. Dr. Haghighat is the utmost professional. He is honest and direct and I have felt that he has taken my care with the utmost respect and has exceeded my expectations for my Periodontist requirements. His staff is also very professional and makes you feel very comfortable in any situation.“