Full Mouth Rehabilitation of a Patient with Bulimia Nervosa Following the Teeth in a Day Immediate Loading Protocol

Thomas J. Balshi, DDS, FACP, Glenn J. Wolfinger, DMD, FACP, J. Neil Della Croce, MS, Stephen F. Balshi, MBE

A poster presentation

Introduction: The purpose of this patient report is to accurately portray the clinical treatment of an active, bulimic patient utilizing an immediate loading dental implant protocol and implementation of a psychometric component, quantifying the psychological effects of treatment.

Methods: A 34 year old, Caucasian, female (Fig.1) presented with severe dental perimylolysis resulting from a 28 year history of varying exposure to acidic vomitus during self-induced purging episodes. The patient was treated with an immediate load dental implant protocol. Psychometric assessment was conducted through administration of the Situational Inventory Body-Image Dysphoria questionnaire, as seen in previous literature. A composite score, computed as the mean of its 20 items on a 5-point response scale, was obtained at the initial visit (T1), 3 mos. post-op (T2) and 7 mos. post-op (T3). Higher scores are indicative of a greater frequency in cross-situational body-image dysphoria and lower scores of a lesser frequency (values range from 0 to 4).

Conclusion: The use of prosthodontic treatment to rehabilitate bulimic patients, provides an expedient and predictable alternative method for restoring esthetics and function. In this case, use of the TIADT immediate loading protocol provided an active bulimic patient with an expedited means to a predictable, long-term, alternative method for restoring esthetics and functional abilities. Psychometrically, the patient's initial scored response of 2.9 (T1) was 3 S.D. above the established mean score (99.8 percentile). Patient scores of .4 (T2) and .5 at final evaluation (T3) respectively, revealed that the patient was no longer significantly different from mean score normative data throughout the final stages of treatment.

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