HOW WE RESTORED A HEALTHY AND FUNCTIONAL SMILE WITH DENTAL IMPLANTS AND CERAMIC CROWNS IN DELHI

CASE STUDY IX– HOW WE RESTORED A HEALTHY AND FUNCTIONAL SMILE WITH DENTAL IMPLANTS AND CERAMIC CROWNS IN DELHI

 

INTRODUCTION: A 31-year-old male patient visited our Delhi clinic with severe pain and swelling in the upper front teeth region. The patient had previously undergone root canal treatment and crown placement on several upper front teeth, but the discomfort had progressively worsened. After a detailed clinical examination and radiographic evaluation, multiple root canal treated teeth were found to have extensive periapical infections and were deemed non-restorable.

To eliminate the infection and restore both function and aesthetics, a comprehensive treatment plan involving dental implants, bone grafting, and two fixed three-unit bridges was recommended. Temporary teeth were provided during the healing phase, followed by permanent all ceramic zirconia bridges on the implants and a protective night guard. The final result was a stable, natural-looking smile with improved comfort and function.

 

PATIENT BACKGROUND: The patient, a 31-year-old male, reported persistent pain and swelling around the upper front teeth. Several of these teeth had undergone root canal treatment and crown placement in the past. Over time, the treated teeth became infected and symptomatic, affecting both chewing ability and overall comfort.

During the consultation, the patient also expressed concern about missing teeth in the upper front region and increasing mobility of one of the canine teeth. The combination of infection, failing root canal treatments, and tooth mobility indicated the need for a more definitive long-term solution rather than retreatment of the existing teeth.

 

INITIAL ASSESSMENT & DIAGNOSIS: Panoramic (OPG) and RVG X-rays were taken to assess the condition of the upper front teeth and surrounding bone. The radiographs revealed severe periapical infections associated with the upper right and left central incisors, upper left lateral incisor, and upper right canine. These teeth had previously been root canal treated and crowned, but the infections indicated failure of the existing treatment.

Additional findings included a missing upper right lateral incisor and significant mobility of the upper left canine. The extent of infection and compromised tooth support made the affected teeth unsuitable for further restorative treatment. Based on the clinical and radiographic findings, extraction of the infected and mobile teeth followed by implant-supported rehabilitation was recommended.

TREATMENT PLAN: The treatment plan was designed to remove the source of infection while restoring the patient’s smile with a stable, fixed solution.

Phase 1: Extraction and Implant Placement

• Extraction of the upper right central incisor and upper right canine.
• Extraction of the upper left central incisor, upper left lateral incisor, and upper left canine.
• Placement of four dental implants in the upper arch, positioned in the central incisor and canine regions.
• Bone grafting around the implants to support healing and maintain adequate bone volume. 
• Fabrication and delivery of temporary teeth during the implant healing period.

Phase 2: Final Prosthetic Rehabilitation

• Impressions for the all ceramic zirconia bridges.
• Jig trial and metal framework trial.
• Final cementation of two three-unit implant-supported bridges.
• Delivery of a custom night guard to protect the restorations from excessive forces.

 

TREATMENT PROCESS:

11/11/2025 – Implant Surgery and Bone Grafting

Phase 1

The infected and mobile teeth were removed, and four dental implants were placed in the upper arch. Bone graft material was added around the implant sites to enhance support and promote optimal healing. The procedure was carried out with careful surgical planning to ensure proper implant positioning for the future bridge. Impressions for the temporary teeth were done.

15/11/2025 – Temporary Teeth Delivered

Interim

Temporary teeth were provided to maintain appearance and function while the implants integrated with the bone.

Healing Period

5 months

The implants were allowed to heal for approximately five months to achieve stable osseointegration.

11/04/2026 – Final Impressions

Phase 2

Accurate impressions were taken for fabrication of the permanent implant-supported bridge. 

18/04/2026 – Jig Trial

Verification

A verification jig trial was performed to confirm the precise fit and alignment of the framework.

24/04/2026 – Metal Framework Trial

Framework

The metal framework was tried in to evaluate passive fit, bite relationship, and overall 

Stability.

27/04/2026 – Unglazed bridge trial

An unglazed bridge trial was performed as an intermediate step to verify the passive fit, marginal integrity, occlusion, esthetics, phonetics, and overall harmony of the prosthesis. Any required modifications were completed at this stage before final glazing and permanent cementation, ensuring a precise and predictable final outcome. 

30/04/2026 – Final Cementation

Completed

The final three-unit all ceramic zirconia bridges were cemented, and occlusal adjustments were carried out to ensure comfortable function. Impressions for a protective night guard were also taken.

02/05/2026 – Night Guard Delivery

Protection

A custom-made night guard was delivered to protect the implant-supported bridge from grinding and excessive biting forces during sleep.

 

RESULTS & OUTCOME: The treatment successfully eliminated the chronic infection affecting the upper front teeth. The implant-supported three-unit bridges restored both the appearance and function of the patient’s smile. The patient was able to chew comfortably and no longer experienced the pain and swelling that had been present before treatment.

Aesthetically, the final restorations provided a natural-looking result that blended well with the surrounding teeth. The use of temporary teeth during the healing phase ensured that the patient maintained an acceptable appearance throughout treatment.

The addition of a custom night guard offered long-term protection for the implant-supported restorations, helping to reduce the risk of excessive wear or overload. Overall, the patient achieved a healthy, stable, and confident smile with improved oral comfort and function.

 

Before Treatment

Implant Placement

Final Result

 

DENTIST’S INSIGHT: This case highlights the importance of early evaluation when root canal treated teeth become symptomatic. Multiple teeth showed advanced periapical infection, and attempting to retain them would have compromised the long-term prognosis. By combining careful implant planning, bone grafting, and a staged restorative approach, a predictable and functional outcome was achieved. The use of a verification jig and metal framework trial helped ensure the accuracy and passive fit of the final bridge. Providing a custom night guard was also an important step in protecting the implant-supported restoration for long-term success.

 

CONCLUSION: For Severely infected teeth with failing root canals, extraction of these teeth , followed by debriding the infection and placement of dental implants and a fixed bridge can provide a stable and long-lasting solution. This patient’s treatment journey demonstrates how comprehensive implant rehabilitation eliminates infection, restores oral health and function and rebuilds confidence in the smile.

If you are experiencing pain, swelling, or problems with previously treated teeth, a detailed examination and digital X-rays can help determine the most appropriate treatment options for your long-term dental health.

Book a consultation today to learn more about your treatment options and begin your journey toward a healthier smile.