How to manage loss of papilla? 23 Mar Patient has a chief complaint of a large gap that has developed between his incisors. What are the treatment options? Is this a good case for Alloderm root coverage? Why incomplete root coverage?
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The gingival recession in this case is not treatable with grafting. Try to identify the cause of this problem: I recommend endo specialist evaluation of 11 and 21; the root canals may be failing and causing an infection in the bone. Once the bone was lost the soft tissue loss followed with recession and loss of papilla.
There is no easy way to treat the loss of papilla between 11 and 21. if the teeth are endodontically healthy, you might consider a bridge from 13 to 23 and keep the teeth. and try to also close the space with prosthetics. Otherwise either endo retreat or extract 11 and 21 then the patient will need a huge bone graft (probably taken from chin) then fixed bridge from 13 to 23 with pontics for 11 and 21 or implants 11 and 21 if the bone graft produces enough bone volume.
Overall this is a complicated and expensive situation to treat.
Approximately $3000-$4000 for the bone graft and removal of 11 and 21. Then about $6000 to $9000 for a big fixed bridge from 13 to 23 or $8000 to $9000 for two anterior implants.
Esthetics could be improve with some pink porcelain to hide the loss of papilla between 11 and 21 in the fixed bridge deepening on the smile line.
Start with the endo consult first that will help to understand what is happening and why.