Pre-op, frontal full-face smile.

Pre-operative smile picture.

Lips retracted, frontal view

Pre-op panoramic x-ray.

Stage one, fixed temporaries. By saving and using strategic teeth we can transition from teeth – teeth with implants – just implants. Non-strategic teeth are then extracted, implants placed and an acrylic fixed temporary fabricated, modified and cemented. This temporary only rests on teeth. Note how much improvement has already occurred!

Progress panoramic x-ray. This x-ray really tells the story, visually. Notice the presence of teeth and implants. When immediate implant stability is not high enough to support the temporary bridge, we use some teeth as abutments (resting spots) for the temporary bridge. This prevents the patient from ever having to wear a temporary denture. This transitional phase allows the patient to be very comfortable while the implants are gaining stability (microscopic adhesion of the implant to the bone) and the temporary bridge is cemented to the strategic teeth.

2 months later, teeth and implants after temporary is removed. The implants are now ready to serve as the anchors for the temporary bridge. At this second surgical appointment the strategic teeth are extracted, additional implants placed (if necessary) and the temporary bridge converted to the implants.

Same appointment as above with teeth removed.

Frontal view of the converted temporary bridge (converted from all teeth supported to all implant supported). The titanium tops are the cylinders that connect the bridge to the implants.

Tissue-view of the converted temporary bridge (converted from all teeth supported to all implant supported). The titanium tops are the cylinders that connect the bridge to the implants.

Occlusal view of the implant temporary bridge. The holes are where the prosthetic screws will pass through to secure the bridge to the implants.

Frontal view of the implant temporary in the mouth. This temporary will stay in place for 2 more months as the bone and soft tissue remodel after the extractions.

Occlusal view after 2 months. The final impression is made. This is the master cast of the implants and simulated gum tissue ready for the final zirconia bridge.

Frontal view, master cast.

Final fixed bridge frontal view.

Right side view, implant bridge.

Left side view, implant bridge.

Occlusal view, implant bridge. Note the screw holes for the prosthetic screws.

Occlusal view of implants in mouth. The gum tissues have matured very nicely and are ideal recipient sites for the zirconia bridge.

Frontal view, day of delivery.

Frontal view with teeth together (in occlusion).

Occlusal view, day of delivery. If you look closely, you can see the final prosthetic screw (blue). This channel is covered with composite resin and patient comfort.

Occlusal view of final, zirconia bridge with screw holes covered with composite resin.

Patient’s new smile.

Lips retracted, frontal view of new bridge.

Right lateral (mirror) view of bridge. Note the “normal” contours that mimic natural teeth.

Left lateral (mirror) view of bridge. Note the “normal” contours that mimic natural teeth.

Post-treatment panoramic x-ray. Note: no angled implants or abutments. Implants are placed where the roots of teeth were. Prosthesis is easily cleaned.

Final, full-face smile. What a difference!

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