Patient Problem
An adult female patient came to our clinic after a fall that injured the front part of her upper jaw. She said she had lost one of her front teeth and that the other one next to it felt very loose and painful. She was worried about both the pain and how her smile looked.
When we examined her mouth, we saw that her upper left front tooth (tooth #21) was completely knocked out, and her upper right front tooth (tooth #11) was very loose and sore to touch. However, the teeth beside them were healthy and not damaged. After conducting an X-ray scan, it showed that tooth #11 had a horizontal root fracture and that the bone in that area had also been affected slightly by the injury.
Proposed Diagnosis & Treatment Plan
The patient was diagnosed with a traumatic loss of the upper left front tooth and a root fracture with severe mobility of the upper right front tooth. Because the injured tooth (#11) could not be saved, we needed to remove it and plan for a long-term replacement of both missing teeth.
We created a three-step plan for her care:
- Initial (short-term) treatment to control pain and protect the area.
We removed the loose front tooth (#11) since it could not be saved. To help the patient feel more comfortable and confident with her smile, we made a small temporary denture and a short-term bridge using a tooth-coloured fibre strip for support.
To preserve the bone for future implants, we placed a bone graft into the empty tooth sockets. She was given antibiotics and antibacterial mouth rinse to prevent infection. - Surgical treatment to prepare for and place dental implants.
After the area healed, we added more bone graft material to make the bone thick and strong enough for implants. Once the bone healed properly, two small titanium implants were placed in the same positions as her missing front teeth. These implants were inserted using a guided, computer-planned approach to make sure they were positioned safely and accurately.
Healing caps were also placed over the implants, and the patient was advised to eat soft foods, avoid smoking and alcohol, and rinse gently with an antibacterial mouthwash for four weeks. - Post-operative care for healing and comfort.
After the procedure, she continued with antibiotics and mild pain relief. She was reminded to use ice packs to reduce swelling and to avoid heavy activity for a few days.
We also made a temporary plastic denture to fill the space and protect the implants while they healed.
Treatment Procedure
The bone grafts and implants were placed over two stages. First, bone was added to build up the area where the teeth had been lost. After the bone healed, we placed the two dental implants using a precise guided surgery method. Each implant was 3.3 mm wide and 11.5 mm long. Both implants were firm and stable at the time of placement.
Healing caps were placed to protect the implants while the gum healed. The patient was prescribed antibiotics, pain medication, and mouthwash. We gave her clear instructions on eating soft food, avoiding alcohol and smoking, and maintaining excellent oral hygiene during healing.
Outcome and Follow-Up
At her follow-up visits, the patient was healing well. The gums looked healthy, and there was no sign of infection or implant movement.
By June 2025, the implants were strong and well-integrated with the bone. The temporary denture gave her a natural-looking smile while she waited for her final implant crowns. She reported being happy with both the comfort and appearance of her temporary teeth.
We plan to place the final implant-supported crowns in the coming months, once healing is fully complete.
Clinical Discussion
This case shows how a dental injury involving knocked-out front teeth can be carefully managed with a step-by-step approach. After trauma, early treatment helps preserve bone and gum shape, which is very important for future implants, especially in the front of the mouth, where appearance matters most.
In this case, we started with pain control, bone preservation, and a temporary replacement to support confidence and function. Later, we used guided surgery to place implants safely and accurately. The implants will eventually support permanent crowns that look and function like natural teeth.
Proper planning, patient cooperation, and regular follow-up visits are key to success in cases like this. The patient was also reminded that good oral hygiene and avoiding smoking will help ensure the long-term health of her implants.
Disclaimer: The information provided on this website is for general educational purposes only and is not intended as a substitute for professional medical or dental advice, diagnosis, or treatment. Always seek the advice of your dentist or other qualified health provider with any questions you may have regarding a medical condition.
Important Note on Surgical Procedures: Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.