Implant Therapy: A Guide to Improved Esthetics

Implant therapy has been a true game-changer for people suffering from tooth loss. As the population ages and edentulism becomes more prevalent, implants as a restorative option continue to grow.

For patients, the idea of placing an implant as opposed to other treatment options such as a three-unit bridge or removable partial denture is a more appealing option. This is especially true when edentulism occurs in the esthetic zone. This area is by far the most challenging and requires proper planning to ensure the case meets the expectations of the patient.

Presenting the Case

Burbank Dental Lab is fortunate to have worked with Dr. Daniel Domingue on the following anterior implant case. As with most anterior maxillary cases, this case is presented with challenges.

The lateral was in need of extraction.

The implant placed was pilot drill guided, and the implant type was an AnyRidge implant by Megagen.

It was determined that immediate loading of the implant was a viable option. Whenever the case calls for replacing one to two teeth in the anterior maxilla, the provisional process can be simplified through immediate loading.

Once healed, the temp can be removed and the soft tissue scanned.

The case was scanned using the appropriate scan body for the implant system used in this case. This scan records the proper height, angle, and implant position.

In addition, a scan of the tissue and opposing was done.

The digital scans were sent to Burbank Dental Lab, where the challenge of designing and fabricating a restoration that maximizes esthetics by blending in with the surrounding dentition began. It is this aspect that is critical in supporting clinicians to ensure overall patient satisfaction.

To ensure these types of cases meet these expectations consider the following:

Case Planning

It was decided to restore with a Burbank Dental Lab, SMART1 custom zirconia abutment with a titanium base.

SMART 1 Zirconia abutments offer a superior esthetic result by eliminating the gray cast shown through the tissue that can be present in some circumstances with titanium abutments.

When designing the abutment, the implant team at Burbank Dental Lab evaluated the patient’s soft tissue, contours, and emergence profile to create the ideal abutment design custom to the patient’s specific needs. Using some of the most advanced computer-aided manufacturing equipment in the industry, the abutment was milled.

The patient’s esthetic needs were evaluated to decide on the restorative material to fabricate the final crown. This step is critical to the overall success of the case as the final crown needs to blend seamlessly with the adjacent teeth.

Proper communication from Dr. Domingue is what led to such an amazing outcome.

The best way to communicate the specific esthetic needs of the case are as follows:

The Final Restoration

Based on all of the information provided and the specific esthetic needs of this case, an E.max crown was prescribed as the final restoration. E.max is an excellent material when esthetics is the number one concern.

E.max has a wide color selection and translucency options, and a wide range of benefits, including:

• High Strength
• Years of successful clinical data
• Wide range of shades and translucencies

The E.max crown was fabricated over the implant abutment. It was cemented to the Smart1 Zirconia abutment using TherCem by Bisco Dental.

The Shade-Taking Process

Considering all the aspects of what makes an implant case successful, including proper planning, skill from both the clinician and the dental lab, and proper detailed communication is what makes all the difference in creating a predictable, functional, and esthetic restoration.

Special Thanks

Burbank Dental Lab would like to thank Dr. Daniel Domingue for letting us provide lab support for this case.