After many years of postponing, the time had come for this patient to fix his teeth. He elected to start on the upper and move to the lower when finances permit. These combination treatments preserve healthy teeth and replace poor teeth with implants. It is a “conservative” approach that many patients appreciate.

Pre-operative smile.

Pre-operative, lips retracted.

Panoramic x-ray, pre-operative.

Panoramic x-ray after surgery on upper jaw.

At the first surgical/prosthetic appointment, bad teeth are extracted, implants placed and natural teeth prepared for crowns.

At that same appointment, a fixed temporary bridge is fabricated on the teeth. This provides a comfortable and aesthetic restoration while the implants heal.

After two months of healing, a final impression is made, a master cast fabricated. This is the master cast with implant abutments and crown preparations (occlusal view).

Master cast with metal framework (occlusal view). This framework will be tried-in the mouth to verify fit and bite.

Master cast with implant abutments and crown preparations (frontal view).

Master cast with metal framework (frontal view). This framework will be tried-in the mouth to verify fit and bite.

Framework try-in (occlusal, mirror view).

Framework try-in (frontal view).

After framework try-in and verification the porcelain is added (fired in a porcelain oven). This is where the character, shape and shade are finalized.