This is the fourth video from my new Dental Excellence video series. In this video I share with you the 15 year post treatment results from my AACD accreditation case.
Watch the video below to find out more and see why I feel this case and others like it have succeeded so well over time.
Remember. You can do this kind of dentistry and that beautiful dentistry with precise fit and occlusion is not just for the gurus!
This is the third video from my new Dental Excellence video series. It is critical to have accurate opposing models which make a huge difference to the fit and finish of restorations when finalizing the occlusion for your patient.
Watch the video below to find out more and see some tips to add precision to your dentistry. Remember that you can do this kind of dentistry and that beautiful dentistry with precise fit and occlusion is not just for the gurus!
Now that the implant is placed, we have several options to consider for interim tooth replacement and/or soft tissue management.
If the soft tissue form is favorable, then an attempt to maintain or support the supra-crestal gingival tissues during the period of osseointegration simplifies the restorative process. By simplifies, I mean that the emergence profile will not need to be developed with a provisional crown.
One way to achieve this is to fabricate a custom healing abutment with the proper shape to provide support for the gingival tissues. To replace the tooth, an interim RPD or a bonded tooth pontic can be used.
Another technique I like to use is a chairside fabricated provisional crown. If the implant is stable at placement, and the occlusal is favorable, then a crown can be attached on the day of surgery.
In this case, I utilized the patient’s tooth. The tooth was trimmed to create a shell crown, and then relined on the temporary abutment in the mouth. The provisional restoration is finished on an analog to ideal contours and then inserted with finger torque.
For this patient, I also added a small piece of connective tissue, that was harvested from the palate. This helps to increase the thickness of the facial gingiva, to minimize the development of a flat or concave contour that so often happens after normal remodeling of the alveolar complex.
The restorative phase was completed with a porcelain veneer on tooth #8 (FDI #11) and a zirconium abutment/ porcelain crown on #9 (FDI #21).
In our next blog posting, I will talk about a patient that required a staged alveolar grafting and implant placement.
Dr. Stephen Phelan graduated from the University of Toronto, Faculty of Dentistry in 1992. He has lectured locally and internationally on the subject of dental implants, occlusion, esthetic and restorative dentistry.
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