The Examiner

Online Edition
August, 2009
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Featured Article
Case Study
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Wade A. Diab, DDS, MS
3900 Frey Road, # 102
Kennesaw, GA 30144
During the last several years, you grew accustomed to The Examiner, a newsletter from our office aimed at keeping you and your staff updated with the latest procedures and trends in implant dentistry and periodontics.  With the growth of our referral network, we decided to go Green. Our hope is you would find this publication informative and helpful.  Your input is greatly appreciated.
Thank you,
Wade Diab, DDS, MS

Oral Rehabilitation After A Motor Vehicle Accident

Motor vehicle accidents can be very devastating to the anterior dentition and dentists are commonly involved in the diagnosis and treatment of MVA injuries. The restorative dentist and the periodontist should work as a team to give MVA victims the esthetic and functional dentition they deserve.
Case Study
 A 19 year old female patient presented to my office referred by her restorative dentist.  She was involved in a MVA five years earlier where she fractured teeth # 8 and 9.  External root resorption was discovered during a follow up radiographic evaluation five years later.  A CT scan was performed of the mandible and confirmed external root resorption on teeth # 23, 24, 25, and 26.  The combined restorative/surgical treatment plan included the following:
  1. All porcelain restorations on teeth # 8 and 9.
  2. Extraction of teeth # 23, 24, 25 and 26.
  3. Insertion of immediate implants on sites # 23 and 26 (Straumann Implants).
  4. Placement of Meso Temporary Abutments.
  5. Immediate Loading with a provisional fixed partial denture.
  6. Healing of eight weeks after the insertion of the implants.
  7. Final restoration: Four unit implant supported fixed partial denture.
Immediately after the trauma in 2003.  Note the swollen lip and the fractured maxillary incisors.
Merritt pre-op
Patient at presentation after 5 years from the MVA.  Teeth # 8 and 9 were repaired with bonded restorations. 
 Merritt cross section
Periapical radiographs and CT scan confirmed the presence of external root resorption.
Flap reflected
Flap reflection at time of extraction of the lower incisors.
Implants in    
Bone Level Straumann implants inserted immediately after the extraction of the lower incisors.
Meso Abutments
Meso temporary abutments placed at the time of implants placement and are ready for the provisional restoration.
Implants x-rays
Radiograph of the implants and the provisional restoration.
Rubber dam placed over temporary abutments and tray placed with Luxatemp.
Post operative photograph after eight weeks of healing.
Impression Copings
Impression copings.
Custom abutments.
 Crowns Prep
Preparation for final restorations on the maxillary central incisors.
Lateral view
Lateral view of the lower fixed partial denture and the maxillary veneers.

Final picture

 Final restorations.
Restorative work performed by Dr. Ashish C. Patel, founder and owner of Dentistry at East Piedmont.
Restorative photographs courtesy of Dr. Patel.
Ceramics by Perry Carroll CDT
© 2009. Wade A. Diab, DDS, MS
Wade A. Diab, DDS, MS
Diplomate, The American Board of Periodontology 
Implants & Periodontal Artistry
3900 Frey Road, Suite 102
Kennesaw, GA 30144
P 770-426-1062
F 770-426-6789