Case 49: A case of Digital Smile Design and Dental Implants in esthetic zone- Complete case
Case 49: A case of Digital Smile Design and Dental Implants in esthetic zone- Complete case
When your patient is highly demanding in esthetics, Its a tough case and a challenging case always until you satisfy the patient's expectation. This case was an example, demanding high esthetics. Patient has had an accident and lost few of her maxillary anterior teeth along with a bony defect and underwent a 5-unit FPD which was not esthetically pleasing.
On analysing using a 2D smile designing done with Adobe Photoshop, The smile curve and symmetry was not in place to achieve the esthetics. Additionally the patient wanted implanted in the anterior edentulous site. After CBCT assessment and clinical examination, it required necessary bone augmentation procedures before implantation. But patient declined the treatment and insisted on other options. The bone was adequate for a narrow implant with additional grafting during the procedure and hence two implants were planned for the missing site at 1.1 and 1.3 with a 3 unit implant supported cement retained prosthesis and individual crowns on 2.1 and 1.4
The entire surgical phase was done under local anesthesia. The existing FPD was removed and Local mucoperiosteal flap was raised for the implant placement. and two implants were placed as planned and additional bulk of bone was augmented with Bio-oss xenograft and Resorbable collagen membrane. An immediate provisional FPD from 2.1 to 1.4 was done with Luxatemp. After a span of 3 weeks, an interim PFM FPD 5units from 2.1 to 1.4 was done as a transitional measure to fullfill the esthetics as per the digital design.
After 6 months, a Cement retained FPD from 1.1 to 1.3 was made with Zirconia and inidividual Zirconia crowns on 2.1 and 1.4 was done to complete the esthetics as planned.
This case was done by me at Parasu Dental Hospital, Chennai
When your patient is highly demanding in esthetics, Its a tough case and a challenging case always until you satisfy the patient's expectation. This case was an example, demanding high esthetics. Patient has had an accident and lost few of her maxillary anterior teeth along with a bony defect and underwent a 5-unit FPD which was not esthetically pleasing.
On analysing using a 2D smile designing done with Adobe Photoshop, The smile curve and symmetry was not in place to achieve the esthetics. Additionally the patient wanted implanted in the anterior edentulous site. After CBCT assessment and clinical examination, it required necessary bone augmentation procedures before implantation. But patient declined the treatment and insisted on other options. The bone was adequate for a narrow implant with additional grafting during the procedure and hence two implants were planned for the missing site at 1.1 and 1.3 with a 3 unit implant supported cement retained prosthesis and individual crowns on 2.1 and 1.4
The entire surgical phase was done under local anesthesia. The existing FPD was removed and Local mucoperiosteal flap was raised for the implant placement. and two implants were placed as planned and additional bulk of bone was augmented with Bio-oss xenograft and Resorbable collagen membrane. An immediate provisional FPD from 2.1 to 1.4 was done with Luxatemp. After a span of 3 weeks, an interim PFM FPD 5units from 2.1 to 1.4 was done as a transitional measure to fullfill the esthetics as per the digital design.
After 6 months, a Cement retained FPD from 1.1 to 1.3 was made with Zirconia and inidividual Zirconia crowns on 2.1 and 1.4 was done to complete the esthetics as planned.
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