Smile makeover with 5 to 5 UL Zirconia screw retained implant supported bridges
Diagnosis:
Patient with wide smile line presented with periodontally involved teeth 5 to 5 UL, #15 teeth mobility 3. Heavy calculus
Patient Expectation:
I love to smile but my smile is not exactly pleasing.
Please fix my mobile teeth and help me eat and smile better
Treatment goal:
Remove teeth with mobility 3, debride and clean sockets.
Graft to maintain bone volume and height
Restore functionality with 5 to 5 UL Zirconia screw retained implant supported bridges
Screw retained prosthesis to allow removal and maintenance of underlying soft tissues periodically in consideration of patients oral hygiene.
Zirconia bridge with pink gums to recreate aesthetic smile in view of patients high smile line.
Improvement of patient facial profile.
No complaints of tmj issues, to maintain current jaw relation.
Patient presented with deep calculus
Very poor OH.
Non ideal smile due to movement of periodontally involved teeth
Diastema between 21 and 22
Full smile- notice high smile line
Full smile- notice Gummy smile, diaestima
Side view of full smile- 11 protruded outwards
Surgical considerations:
High chance of implant failure and peri- implantitis - managed by prophylaxis prior to and after procedure
-through debridement
-Reduction of bone height provides sufficient soft tissues to allow grafting of sockets and creating sufficient bone volume around implants.
8 neobiotech IS II Active fixtures installed, maxillary fixtures are fitted with Multi unit angled abutments to redirect screw channels to occlusal surface and allow passive seat of prosthesis with uniform path of insertion.
Sockets grafted.
Lips in ripose
Full smile- zirconia bridge fabricated by Neobiotech Cameleon 5-axis milling machine (6 years still in service)
Smile line redifined with pink porcelain on zirconia bridge.
