0 Evaluation & Diagnosis
1 Progress & Completion
2 Follow-Up & Outcome

Patient cases:

Single-unit restorations

(Maxilla / Anterior)

Single maxillary implant and crown with pink cervical porcelain

Lead:

Charles Goodacre

A 57-year-old female patient presented herself with a missing maxillary left central incisor and wanted a fixed replacement. Since the adjacent incisors were already restored with adequate metal-ceramic crowns, a single implant and crown were used to replace the missing tooth. Because the peri-implant mucosa was located apical to the normal location, the definitive crown was fabricated with gingival-colored cervical porcelain to provide a more esthetic result.

Evaluation & Diagnosis

Initial situation with healing abutment showing lack of mucosa.

Gingival shade was selected because there is a need for gingival-colored porcelain as part of the definitive crown.

Preferred 1M2 shade was selected to determine if a good color could be found to match the existing crowns.

Periapical radiograph: implant placed with healing abutment.

Progress & Completion

Implant placed and mucosa healed but deficient in volume.

Internal connection and mucosa of implant.

Cast gold custom abutment, facial view.

Periapical radiograph: implant with custom-made abutment.

G3 was selected as best shade for gingival porcelain.

GM4 gingival shade (closest available but does not match).

G3 best shade for gingival porcelain.

GM4 gingival shade that will be used for part of the gingival porcelain.

Preferred 1M2 shade tab from 3D Master shade guide held next to central incisor.

Maxillary cast mounted.

Maxillary cast looking down into implant analog. The facial positioning of the implant contributed to the lack of adequate facial mucosa.

Custom cast gold abutment closeup.

Crown on cast facial view with flexible gingiva.

Crown on bench, facial close up.

Crown on bench, cervical view.

Definitive crown seated.

Close up of definitive restoration.

Smile, 1 month after insertion of definitive restauration.

Questions

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Team members

Prosthodontists

Thomas Kepic

Periodontist

Satoshi Sakamoto

Dental Technician

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