Question: 1. please see the attached xray - can the teeth be saved or do they need to be extracted. they are loose and are in discomfort. could periodontal procedures and bone grafting fix the problems?

2. is it possible to get dental implants that match the shape and size of the extracted teeth?

grade 2
Can bone grafting be done to help?

why do you think it is better to get the teeth extracted?

There is significant attachment loss -- why is the teeth loose? could the ligiments just be streched? there has been significant attachment loss this year. can they rebuild the bone ?

How soon does bone grafting need to be done . If there is no bleeding could it be anug?

Is it possible to do the whole mouth at once?

If the bone grafting is successful can the teeth become stable (no mobility)

If the tooth needs to be extracted due to gum disease, which causes bone loss, the situation only worsens. Your body is trying to “self-extract” your tooth by dissolving the surrounding bone and making it loose.

Is the above something to worry about

Also, do you recommend getting a mold done of the real teeth to get the implants and crowns made exactly the same?

what is the best way to have the crowns and implants look exactly the same as the real teeth. what are the most expensive type of implant


and can the crowns and implants be put in at the same time

also can the teeth tighten up on there own? there is 4mm of recession

Can bone grafting and dental implants be done at the same time?

Could you also review the attached images - what is the lesion on the tongue - it gets bigger and smaller depending on the day. is it cancer?

also, how urgent do the bone grafts need to be done?

if you were the patient in the x-rays, what would you do? would you get the teeth extracted?>

would you recommend Growth factors. Platelet derived growth factor and the bone morphogenetic proteins in this case>? what about
14. Bone loss is the major concern - Whhich of the following treatments would I be good candidate for:
a) Bone grafting. This procedure is performed when periodontitis has destroyed the bone surrounding your tooth root. The graft may be composed of small fragments of your own bone, or the bone may be synthetic or donated. The bone graft helps prevent tooth loss by holding your tooth in place. It also serves as a platform for the regrowth of natural bone.
b) Guided tissue regeneration. This allows the regrowth of bone that was destroyed by bacteria. In one approach, your dentist places a special piece of biocompatible fabric between existing bone and your tooth. The material prevents unwanted tissue from entering the healing area, allowing bone to grow back instead.
c) Enamel matrix derivative application. Another technique involves applying a special gel to a diseased tooth root. This gel contains the same proteins found in developing tooth enamel and stimulates the growth of healthy bone and tissue

why would you go for implants if things could help save your teeth>

not painful
it does come and go
it does increase and decrease in size

can you tell by the xray that we sent if there is any cavities or decay n the tooth? it is in discomfort (constant)

also I will attach pictures. can you please let us know if there is decay or cavities in the tooth?

see attached

are root cavities or decay visabile on xrays

could you please look at images :

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• IMG_0007.JPG      

• IMG_0007.JPG      

Please let me know if thre is a symptom of anug in the pictures

It feels like there is an infection / bad taste in the side of the mouth where the X-ray is . Fees like it should be sucked out . What is going on?


But I've been told there is no active gum infection periodontal disease


can the teeth in the xray be saved they are mobility class 2

what do you mean infection? what type of infection

is it aggressive periodontitis?

I met with a periodontist 1.5 weeks ago and they said there is no gum or periodontal disease?

what about the pain in the area of the mouth? is this due to an infection or a loose tooth?

is there any chance it is trench mouth?

see attached - gums have improved since this picture

also
I had bonding done on 6 upper teeth that I terribly regret. the dentist took a lot of the natural tooth before doing the bonding. I am curious if the bonding can be taken off and the exact shape of the original tooth restored if necessary

2017-05-24

Thank you for your answers so far. Could you please help me with the following questions? Here are a list of questions that I have for a periodontist (could you please help me by letting me know if I need to ask further questions).

Priority
1. What treatment is needed
1.     I was told by a periodontist that I need bone grafting to save my teeth. Could you do this for me? If so, when does it need be done by?
2.     Why are my teeth loose? Can a periodontist rebuild the bone for me? I am having pain in the location of the loose teeth

3.     What is my diagnosis? Could you please provide a treatment plan for me? What are treatment options could you please offer me?
4.     What would be the top of the line / best treatment options available?
5.     Can you repair my gum recession for me without using palatal tissue? Can you reconstruct my periodontal tissues? One option I received PRP with a collagen membrane and bovine bone graft in each area of my mouth.
6.     Do I have active gum disease? If so, can you slow down progression of my disease
7.     Would you recommend Advanced regenerative technologies on me – for example new barrier-membrane techniques, cell-growth-stimulating proteins or gene-delivery applications? have entered the clinical arena.
8.      Do I need to reduce coffee intake?
9.     Can my bite be fixed? Would this include corrective jaw surgery? I already
10.     Can you perform imaging to keep track of the progression of my bone loss,etc? could you please describe options for me?
11.     Could I still obtain orthodontic treatment - I doubt it but I read sometimes it could have a positive impact on periodontal treatment

Other
12.     Why are my teeth loose? Can you rebuild the bone for me?
13.     What are treatment options could you please offer me?
14.     What is my diagnosis? Could you please provide a treatment plan for me?
15.     What would be the top of the line / best treatment options available?
16.     Can you repair my gum recession for me without using palatal tissue? One option I received was PRP with a collagen membrane and bovine bone graft in each area of my mouth. What options do I have?
17.     If I need dental implant sin the future. Is it possible to get each individual tooth to look the same size and shape as my current teeth? If so, can you prepare molds of my teeth and a 3D CAT scan for me? What would you recommend?
18.     Do I have Acute necrotizing ulcerative gingivitis or any type of active gum disease?
19.     Will drinking coffee increase my bone loss?
20.     Should I be taking doxycycline?
21.     I sometimes feel like I need to suck food out the my upper right portion of my teeth. Is there an infection there?
22.     I’ve read about some of the cases at the University of Michigan Dentistry and some of your research.
23.     Do you recommend Platelet Dervived Growth Factor or Emdogain
24.     old male patient was conducted, to evaluate the bone regeneration using collagen sponge with metronidazole 4.5 mg in horizontal defect. From the presented case, it can be concluded that collagen sponge with metronidazole is clinically and radiographically efficacious in the treatment of a horizontal bone defect. Thus, signifying its role as a regenerative material in the treatment of horizontal bone defects
25.     Can you something to relax me during surgeries? Sometimes back gets uncomfortable and I have trouble sleeping the day before surgery.

Why do Is there a food taste (sometimes) like peanut butter in the area of The mouth in the X-ray ?

also, if the pockets are 3-4mm and the gum recession is 2mm or 3mm does that mean the pocket is really 6 mm?

is that indicative of gum disease

for dental implants can each tooth have its own dental implant which has the same size and shape as the previous natural tooth

I don't like on a bridge how the teeth are fused together. can I get individual implants for each tooth. can I also send you some xrays to determine if you recommend extracting the teeth or not? pls see attached

can the bone be rebuilt?

if there is no bleeding does that mean the patient doesn't have Acute Necrotizing Ulcerative Gingivitis ?

I hhave 2 more questions:

1. I've attached 2 X-rays - is there increased bone loss?
2. Also are the loose teeth (molars) that we were discussing going to need to be extracted soon? I do not want to leave them in that condition.

Does severe gum recession need to be treated? what happens if it is all over your mouth?

what do you mean "teeth from falling"?
is the bone loss getting worse because of the gum recession?

why would a periodontist tell me not to floss a certain area with a lot of gum recession?

it was in the area of the loose teeth in the xray that I shown you. when I floss they become looser

should a patient be brushing their gums?

please see attached
the gums are in almost constant pain (too filled up with food I think might be the problem) what do you recommend?

is there any chance at guided tissue regeneration

do you think all of the teeth in the picture need to be extracted

who extracts the teeth? a dentist?