Before and After Success Stories
Worn Dentition
Before
Challenge: Advanced wera and acid erosion involving all the remaining teeth. Shifting of remaining teeth resulted in the growth of bone that houses the teeth, subsequently when the teeth are brought together, the gums of the upper arch almost touched the lower arch. The teeth had short roots due to previous history of orthodontics.
Treatment Plan: Working with our interdisciplinary team’s oral surgeon, the remaining teeth were extracted and aggressive alveoloplasty performed, followed by the placement of six dental implants on the upper arch and five dental implants on the lower arch. Fabricated a removable palate-less macillary prosthesis and a mandibular fixed hybrid were fabricated.
 During  After |
Interdisciplinary Team
Before
Challenge: Worn teeth with an edge to edge occlusion, anterior crossbite, lack of canine guidance due to early loss of #6, periodontitis and localized recession.
Team Treatment Plan: An interdisciplinary meeting with the orthodontist, periodontist and restorative dentist produced the treatment plan. Implant site development, occlusal issues, periodontal treatment, leveling and aligning the arches, as well as final restorative materials were all considered with final tooth position and sizes driving the decision-making process. Treatment sequence was determined and followed over the course of 3 years.
 During  After |
Single Tooth Implant in an Esthetically Compromised Site
Before
Challenge: A recurrent infection of an apicoectomy on #10 and resultant buccal fistula. The buccal cortical plate has been destroyed from both surgery and infection. There has been loss of papilla and alveolar bone height, particularly on the distal. The challenge is to rebuild what has been lost through grafting and prosthetic technique. The goal of treatment is to have dental and gingival contours that are indistinquishable from the natural teeth.
Treatment Plan: An atraumatic extraction and socket preservation with bone and soft tissue grafting. After healing a dental implant was placed with secondary soft tissue grafting. The implant was uncovered after osseointegration and immediately provisionalized to promote and support the new gingival architecture. A custom milled Zirconia abutment and crown was fabricated. Note teh dental and soft tissue contours that duplicate the patient’s natural denttion and are hormonious with the patient’s function and esthetics.
 During  After |