Treatment: Dental implants in the esthetic zone: replacing two front teeth
Yili was self-referred to our clinic after sustaining a broken front tooth. She had traumatized her two front teeth many years ago and had received various treatments to salvage and maintain them over the years. These teeth had fractured at the gum level and subsequently required root canal therapy, build-ups including posts, and crowns.
Over the years repeated loosening of the crowns and deterioration in their appearance had prompted her to seek an alternative more permanent solution that eliminated many of the issues associated with her current prosthesis. In addition to improved functional capability and long-term stability, achieving an optimal esthetic outcome was of paramount importance.
"Successful execution of dental implant therapy in the esthetic zone demands a higher degree of technicial expertise and proficiency."
DR. KAMRAN HAGHIGHAT, B.D.S., M.S., P.C.
The extent of the dental trauma had rendered them weak despite the effort made for their reconstruction. It is not uncommon that subconsciously such patients avoid using their teeth for normal function, such as biting into food out of fear that they may not withstand the forces.
Her search for a better alternative led her to the Portland Perio Implant Center where we pride ourselves to be at the forefront of the most current and advanced innovative techniques in dental implant therapy.
A thorough clinical and radiographic assessment which included a 3D facial scan was undertaken to qualitatively and quantitatively assess the bone in this area. Successful execution of dental implant therapy in the esthetic zone demands a higher degree of technical expertise and proficiency.
Success is highly defined by the esthetic outcome of therapy. With the current knowledge and advancements in surgical and prosthetic techniques, an integrated implant that does not fulfill this criteria in the esthetic zone is not considered a success, especially from the patient's perspective. In-depth knowledge of the biology of the soft tissues as well as experience in their surgical manipulation and management plays an important part in achieving the desired outcome.
Maintenance of the proper form and contours of the soft tissues around the newly installed implants was achieved through minimally invasive surgical techniques that avoid incisions or sutures, and the use of immediate same-day temporary crowns. In addition to maintaining the tissue contours, immediate temporization provides patients with same-day teeth that is secured and not removable.
Having discussed the various options of therapy, we decided to replace both the upper central incisors with dental implants. Placement of two adjacent implants in the esthetic area poses many challenges and should be planned and managed carefully. In such cases, maintenance of the soft and hard tissue in their optimal form is difficult. In planning this case we decided to sequence the treatment for Yili by treating the teeth one at a time over a number of months. We first treated the broken tooth by same-day immediate implant therapy with a temporary crown.
Once satisfactory healing was achieved, the second tooth received similar therapy. After both implants were integrated, the final restorations made from zirconia and ceramics were fabricated and delivered.
She is now enjoying a more beautiful smile and once again has regained the confidence to enjoy the foods she had avoided previously.
Thank you Yili, for trusting us with your smile.
In the patient's own words:
"Had two dental implants done by Dr. Haghighat and his fantastic team. The entire office is extremely professional, reliable and prompt. I never had to wait more than 3min to be taken back to the patient rooms. Dr. Haghighat is highly skilled and takes great care of his patients. My implants turned out beautifully and I would highly recommend this practice to anyone needing an implant."
