Aly Virani presents an implant case that highlights the current antibiotic prescribing trend and the importance of the appropriate use of CBCT.
Some words just belong together – for example: moisture control and bonding; border moulding and dentures, and obturation and endodontics. Curettage and extractions, perhaps? How about cone beam computerised tomography (CBCT) and implants? Thankfully less frequently, dental infections and antibiotics.
Certain principles are tied to clinical procedures, drummed into clinicians all the way from the clinical years of undergraduate training – but perhaps not all of the necessary ones, and sometimes protocols go out of the window after our final exams.
Sticking to the rules isn’t so easy when we have a population of real people to look after, with their lives and their problems and their pain all in your hands.
I’m always pleased to hear a patient say that the referring dentist left the tooth in situ as ‘implant dentists prefer to take the tooth out themselves’.
More often, I hear about the multiple courses of antibiotics that were kindly provided to try to extend the life of teeth. And, increasingly from within the dental profession, I hear about the potential dangers of overusing CBCT.
I hope that sharing the following case will stimulate some discussion amongst our profession about the current trends and how we might consider these principles in the context of cases such as this one.
Case study
This female patient presented for a consultation to discuss replacing her UR2 with an implant. It had been six months since the root had been removed by her dentist after the post crown had failed.
The extraction was preceded by four courses of antibiotics in the previous 12 months to treat the recurrent buccal swellings. This cycle was ended by the prosthetic tooth debonding, revealing a fractured root that could no longer be restored.
The patient didn’t like wearing a removable denture and decided that it was time to explore the options. Clinically, the appearance of the tissues and the ridge form were good, suggesting no signs of underlying defects.
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