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Treatment provided by Dr Andrew Nixon (implant-restorative dentist), Dr Peter Vaughan (orthodontist) and Dr Paul Coceancig (oral & maxillofacial surgeon).
This 19 year old female never developed her upper right lateral incisor. This common condition lead to a shift of her maxillary midline, which ultimately was corrected by her orthodontist.
Orthodontic management required the creation of a lateral incisor "space", and which ultimately would be replaced to provide smile symmetry.
The space had been temporarily filled by a Maryland bridge, incorporated into a fixed orthodontic retainer wire. This temporary aesthetic measure allowed for bone grafting, and then later implant replacement to the area...
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Photo showing smile at presentation to surgical office. Note the plastic tooth (replacing the lateral incisor) which is adhered via a common wire linking the back surfaces of the adjacent canine and central incisor teeth. Braces remain on the lower teeth. |
Her treatment options were a denture or a bridge. Instead the patient elected to listen to her orthodontists and dentist, and seek implant treatment with an oral & maxillofacial surgeon.
Initially a small bone graft was harvested at the time of her wisdom teeth removal, and this was transposed to the bone above where the implant would ultimately be inserted. After 3/12, the implant was placed, and the gum moulded around a "healing abutment".
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X-ray image of osseointegrated titanium implant with attached healing abutment |
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Clinical photo of implant with attached healing abutment, 3 months after initial implant insertion. Throughout the integration period, a temporary partial denture is worn to fill in the gap. |
Final photo showing perfectly colour matched crown.
The aims of the implant should be for perfect replication of the lost tooth. The oral & maxillofacial surgeon cannot work alone however.
Whilst a surgeon is capable of restoring bone and soft tissue contours, as well as place the titanium implant product, the implant restorative dentist is required to actually place the final aesthetic crown.
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