While using a byte day aligners, patient was examined by their dentist; intraoral exam revealed generalized 2mm to 9mm probing depths.There is extensive generalized subgingival calculus detected.Advanced mobility is noted at #24 and #25.Radiographic exam revealed generalized moderate-severe horizontal bone loss, as well as complete loss of bony support at #24 and #25.There is also extensive bone loss at #23 and #26 mesial, as well as evidence of vertical bone loss present at several sites.Subgingival calculus is also detected.Dentist recommends the following: 4 quads of scaling and root planing for phase 1 periodontal therapy.After treatment is complete a review will be made as for phase 2, if surgical therapy is required - extractions.A cbct scan was done which revealed severely limited dimension of bone for implant therapy at #24 and #25.Widened pdls are also noted at several teeth which is likely due to recent orthodontic movement.These sites are not recommended for implant therapy due to the lack of adequate vertical bone.Alternative replacement options were reviewed.Dentist recommended extractions of #24 and #25 with bone grafting in order to help attempt to preserve the bone on the mesial aspects of #23 and #26.Patient has chosen to move forward with the recommended treatment.
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