Case Studies

Personal Injury

Case 1:

Loss of single incisor tooth as a result of trauma

Treated by Peter Briggs
Young patient lost upper left central incisor during road traffic accident. Patient was otherwise well and dentition in generally in good condition.
Her fixed restorative replacement options were :

• Single tooth implant (with grafting)
• Resin bonded bridge
• Conventional bridge

Removable options were :

• Acrylic denture
• Chrome cobalt denture

• Pre-operative view
• Post-operative view – following implant crown UL1

Case 2:

Multiple dental, bone and facial injuries following road traffic accident

Treated by Peter Briggs
31 year old patient sustained serious facial and dental injuries when he was knocked off his bike by a car. He lost seven previously intact teeth together with supporting alveolar bone. He was in hospital for several days. He required operations for fractured bones (leg and mandible). He then required a significant amount of restorative dental treatment.

His fixed restorative treatment option was:

• Implant supported restorations (with hip grafting)

The removable treatment options to replace his missing UR321, UL1, LR321 and LL12 were:

• Removable acrylic dentures
• Removable partial Cobalt Chrome dentures

• Immediate post-accident condition ( seven teeth lost from upper and lowe jaws). Wires and arch bar used to repair mandibular fracture
• Occlusal view of upper implant bridge supported by two implant fixtures following bone grafting
• Post-operative view of lower implant supported bridge
  following hip graft
• Overall labial view of implant supported bridges (seven implants placed following bone grafting from hip)

Medico-Legal Negligence Case examples

Case 1:

Aesthetic and Functional Problems associated with Ceramic Veneers

Patient unhappy with both the appearance and function of 14 ceramic veneers placed 24 months earlier. The patient was unhappy that several of the veneers had de-bonded on several occasions. He was also unhappy with the quality and overall appearance of the restorations. He had not been able to achieve a satisfactory resolution to his complaints with his previous dentist. Peter was instructed to provide an opinion on breach of duty, causation, condition and prognosis by his solicitor. They also wanted to know what treatment would be required to rectify the present situation, and advice on its long term predictability

• Labial view
• Palatal occlusal view

Case 2:

Problems associated with implant supported crowns

This patient was unhappy with the aesthetic appearance of her implant restorations. She was unhappy with the length of the three implant restorations and the fact that the gum height of the implant restorations was higher than that of the neighbouring teeth. She was also unhappy with the metal showing at the neck of the restorations and keen to know what could be done to improve the situation. She was unable to resolve these problems with her dentist. The patient was referred to Hodsoll House for an opinion on her present condition, prognosis and future treatment options

Case 3:

Implant Restoration Failure (fracture and de-bond)

This patient was unhappy with the aesthetic appearance of her implant restorations. She was unhappy with the length of the three implant restorations and the fact that the gum height of the implant restorations was higher than that of the neighbouring teeth. She was also unhappy with the metal showing at the neck of the restorations and keen to know what could be done to improve the situation. She was unable to resolve these problems with her dentist. The patient was referred to Hodsoll House for an opinion on her present condition, prognosis and future treatment options

• Implant restorations in situ
• Fracture and de-bond of implant restorations

Case 4:

Endodontics and Post Crowns

Patient was unhappy with dental treatment provided for her lower left 6 and 7. Following root canal treatment of both teeth they were restored with post crowns. The patient was unhappy to develop pain and infection in the lower right quadrant when on holiday. The treating emergency dentist informed her that there were serious problems with both teeth. They informed the patient that there were likely perforations associated with several of the posts and that there was likely to be caries still present at LL7. They also suggested that there looked to be a separated endodontic file in one of the mesial root canals of LL7.

The patient was referred to Hodsoll House for an opinion on liability, future prognosis and causation.

• Radiograph of LL67