Dentaltown May 2022 - 20
message board
Anterior Adjacent Implants
The patient is thrilled but this Townie needs to know why his implant result wasn't ideal
DocHollidaze
Member Since: 11/28/18
Post: 1 of 28
I have a case I'm working on and would love to hear everyone's thoughts/advice. This 55-yearold
patient presented to clinic with mobile #7 and #8. Referral to periodontist. Decided to ext,
bone graft and implants (Zeramex). Patient returned to offi ce for restorations (see photos). Implant
collar on #8 slightly visible supra-g; I took impression and sent off to lab to get a better idea of what
it may look like in the end. Abutments placed and crowns placed.
Asked patient what her thoughts were and then shared mine. The crowns look great (need
minor shade adjustment). No papilla, and abutment more visible than I hoped. The defects are
not in the smile line and would have to displace the lips to really identify the black triangle and
defect. Patient ready to be done with all this, understandably so, but I mentioned the outcome
is not what I had imagined.
I've reached out to the lab to discuss options and I will also reach out to the periodontist
soon. I just would like anyone's expert advice/opinions on this case and how to make it the best
possible outcome for this patient. Thank you. ■
3/9/2022
shpinatlanta
Member Since: 02/19/06
Post: 2 of 28
From my own experience, it's just about impossible to get symmetry on cases like this.
With these two implants side by side, it will be diffi cult to get a good outcome without some
pink porcelain. In this case, it's hard to tell what the fi nal bone graft looked like before implant
placement. You defi nitely need as much bone as you can get. What I do is usually place one
implant and cantilever the lateral pontic.
Here's a similar case:
Left: Cracked root #8,
had to be extracted.
Right: GBR, stuffed
sausage technique.
Left: Defi nitive prosthesis,
#7 is cantilever pontic.
Right: Luckily, she has
a lopsided smile. ■
3/9/2022
20 MAY 2022 // dentaltown.com
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