Congenitally Missing Premolar I

Updated: Mar 5, 2019

When adult teeth never develop in the posterior maxilla, bone volume frequently becomes a challenge.

Pneumatized maxillary sinus due to congenitally missing premolar

34 year old female with a missing maxillary right second premolar wanted to replace missing function with a dental implant. Both adjacent teeth were healthy and a fixed bridge was declined.

Bone Volume

Without a developing tooth bud, maxillary and mandibular bone volume can be severely diminished. In the mandible this can result in an edentulous span that is thin bucco-lingually and short corono-apically. Horizontal and vertical augmentation would be necessary. These three dimensional changes are also possible in the maxilla but with an additional complication of sinus pnuematization, where the sinus dips into the edentulous space.

Sinus Grafting and Implant Surgery

Sinus Grafting was performed to increase bone height in preparation for a dental implant. After six months of healing, the graft was mature and ready. Dental Implant surgery was uneventful and after 10 weeks the patient was referred back to her general dentist for restorative work.

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