This patient presented with non-restorable upper teeth due to deep caries, missing teeth, and failing dental implants from advanced peri-implantitis. She wanted to replace her missing teeth, regain her smile, and be able to chew again comfortably with no pain. The most important factors for patient was having a fixed transitional restoration at all times and deliver a highly cosmetic result.
The treatment was provided with a staged technique with gradual extraction of teeth, bone and soft tissue grafting, and placement of implants in order to provide her with a fixed transitional provisional restoration at all times. Digital workflow and computer-assisted planning and 3-D printed surgical guides were used for precise placement of dental implants.
The gingival tissue was ‘trained’ using the provisional restoration.
The critical consideration was preservation of bone and gum tissue during extractions and implant placement. This was achieved using site bone grafting, partial extraction therapies, and carefully fabricated transitional restorations.
The final outcome was a beautifully designed and fabricated set of teeth completely supported by dental implants with sculpture of natural gum tissue.