This is a young female who presented to us for evaluation and treatment. Tooth #8 had been treated endodontically and a poor fitting crown. Tooth had recurrent caries and loss of proper foundation for the crown.
The adjacent tooth also had an old crown with poor margins and aesthetics. Patient wanted to replace both teeth. She was extremely concerned about the final cosmetic outcome and specifically looked for a team of dentists in close collaboration to help her.
Initially, the crown on tooth #9 was removed and a provisional restoration was fabricated. This restoration was a cantilever bridge with #9 as abutment and #8 as pontic. The provisional restoration was also duplicated to fabricate a surgical guide.
Next patient was seen by Dr. Kazemi who extracted tooth #8 and immediately placed an implant with minor grafting to augment and preserve the coronal tissues.
The provisional restoration was replaced. After a 3-month healing, the implant was exposed and a standard healing abutment was placed. Right away, patient was seen by the prosthodontist for fabrication of an implant-supported provisional restoration. Ideal tissue architecture was formed using the provisional restoration. A final impression was done with tissue capture in preparation of the final restoration.
Implant was restored with a screw-retained one piece Zirconia-porcelain resoration and tooth #9 was restored with a conventional tooth-supported crown. We were able to achieve a wonderful result with great aesthetics which patient loved.