Unexpected sequel to silver fluoride followed by stannous fluoride
treatment of root stumps supporting an overlay denture in an aged-care patient
Abstract
An institutionalized high care dementia patient, who is unable to maintain his own oral health, presented with five lower anterior carious root stumps supporting a lower overlay denture. Due to limited cooperation, his root stumps were treated with only silver fluoride followed by stannous fluoride applied topically on a 4-month cycle.
Almost one and a half year after his initial application, there were unexpected calculus formations on the root stumps accompanied by marked gingival inflammation and gingival hyperplasia. At this point prognosis was considered very poor. Because the patient’s cooperation was poor, no attempt was made to remove the calculus deposits. Following continued topical applications directly to the area, there was evidence of a marked and unexpected improvement in gingival health. Some 4 years and 4 months after the initial application, the root stumps demonstrated a hard glossy surface surrounded by healthy gingival tissue.
There had been no change in the patient’s oral care, minor changes to medications and there had been no operative or periodontal interventions.
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