Rehabilitation of a bulimic patient using endosteal implants

This article describes the dental rehabilitation of a bulimic patient using endosteal implants. Although the patient, a 31-year-old woman with a long history of bulimia nervosa, had been receiving medical and psychological treatment, the condition was not completely controlled. Clinical examination revealed multiple crowns with extensive cervical caries. The prognosis for all remaining teeth was poor. After extractions, implant therapy was implemented to provide support for fixed prostheses. After the implants were uncovered and during provisional therapy, the peri-implant tissue exhibited inflammation and lack of keratinized tissue requiring additional periodontal procedures before definitive restorations could be placed. Because of the difficulty in managing the peri-implant tissue during the many phases of implant therapy, treatment was challenging. One year after treatment, the patient's low self-esteem had improved substantially and her restorations provided satisfactory esthetics and function.