Case study
Case Study 2
This case is an excellent example of INTERDISCIPLINARY dental planning. We utilized 2 general dentists, and orthodontist and a periodontist to get this incredible result.
This is awesome patient that I have known since moving into the freshman dorm at college!
step one
step ONE
She presented with an existing Maryland bridge to replace a missing tooth #7. This has been there for 35 years. With time, the metal on the back of the bridge cracked. We knew this was a matter of time before we would have to replace this bridge. When we took photos and analyzed her smile, we noticed that #8 was canted (or the root was tilted to the left). Upon discussing with the patient she said she had also noticed this and that she did NOT like it. Now, this added to the complexity of this case. We needed to consult with an orthodontist to try and move the root of tooth #8 to make room for a dental implant to replace missing tooth #7. This was a TIME investment and a FINANCIAL investment for the patient and it also meant wearing traditional BRACES.
step two
step two
Here is how the treatment went down.
Maryland bridge was removed
Ortho put on with an artificial tooth in the place of #7.
Her other lateral, #10, was slightly undersized so the orthodontist made that space wider during her treatment. This meant there would need to be a porcelain veneer done at the end of treatment.
Implant for #7 was placed, by our periodontist, during her active orthodontic treatment and allowed to osseointegrate.
step three
step three
A connective tissue graft was done on tooth #5 and tooth #6 to cover the recession and thicken the keratinized tissue, the result was AMAZING.
step four
step four
Once the implant was integrated, we placed a CEREC made temporary implant crown to help with tissue conditioning. This was worn for 4 months.
step five
step five
We made a custom impression coping for her dental implant and impressed for both the implant crown and veneer. Emax veneer and an emax crown cemented to a zirconia custom abutment with an angle correcting screw. This allows the crown to be screw retained, which is AWESOME.
