Blog By: Dr. Shivangi, True Value Dental Institute
Nowadays, seeing this condition, we usually start thinking about extraction, implants, GTRs, augmentation etc.
But on the contrary,
Here is a review of few cases by Dr. DANIEL MELKER, USA. He saved these teeth by conservative methods. Look below how he did it.
Dentistry is a very technical profession. Do you wonder that dentistry as a profession was originally made to save teeth? But with the advent of new techniques for restoration and replacement of teeth, the concept of conserving the original tooth in the first place has gone obsolete.
Dr. DANIEL MELKER, USA, is one such dentist who also believes in conserving the teeth first like we do at True Value Dental Institute. He posted such wonderful cases of CONSERVATION OF HOPELESS TEETH on social media that I could not resist sharing them with you.
So in this article, we shall discuss the treatment procedure for grossly decayed teeth or hopeless teeth without extracting them.
CASE 1: Grade and analyze the tooth for the conservation work.
On the basis of:
- Symptoms: No pain, No sensitivity, chronic caries, old restorative work.
- Clinical Signs: No frank/active infection. Chronically grossly decayed. 30-50% tooth structure remaining for restorative work and support.
- Age: old age patients have age changes in the pulp.
- X-rays: No pathologic changes in and around the tooth in relation to clinical condition.
Consider the following of a 74 year old patient. Observe the tooth which is grossly decayed and its subsequent transformation and prognosis.
Pre-op pictures
Post-op pictures
Radiographs: No Endo. Required
Image courtesy: Dr. Daniel Melker
CASE 2: There is no better implant than the tooth itself!
We, as dentists, loose hope after we see any tooth which is hopeless. The easiest thing to do is extraction and implants. But what if I say that save the teeth and use them as implants.
Consider the following case:
Pre-op pictures
Post-op pictures
After 13 years follow-up: Amazing prognosis
Image Courtesy: Dr. Daniel Melker
CASE 3: Saving tooth- A Periodontist’s forte!
There are times when the oral hygiene of the patient is so compromised that the only way to restore the teeth is through replacement by dental implants. Nevertheless, we should not lose hope for the hopeless teeth.
Consider the following case:
Pre-op pictures
Post-op pictures
After 10 year follow-up- Incredible restorative and prosthetic work
Image Courtesy: Dr. Daniel Melker
This is the power of conserving the teeth.
Before concluding, I remember Dr. William Hunter, Physician, 1910, McGill University, who criticized the prosthodontists of USA that all the gold fillings, caps, bridges and dentures which they did were being built around and upon islets of frank infection that instead of eliminating sepsis, were responsible for its perpetuation.
Conclusion:
The CAUSE of most dental problems lies in the bad oral hygiene.
Dr. William Hunter, Physician, 1910, McGill University, criticized the prosthodontists of USA that all the gold fillings, caps, bridges and dentures which they did were being built around and upon islets of frank infection that instead of eliminating sepsis, were responsible for its perpetuation.
According to Dr. William Hunter, we as dentists work in a pool of sepsis in the patient’s mouth. So the prime agenda should always be on the reduction of infection. This can be done by making the patient aware of the mouth condition and making them understand how to maintain the oral hygiene with the help of brushing techniques and prophylaxis.
Teeth are like diamonds and they are much more worth than any restorative procedure. Save them!
Blog By: Dr. Shivangi, True Value Dental Institute
