History of chronic failing restorations on teeth and implants with a strong bite.
To reconstruct debilitated and worn dentition using dental implants to replace missing teeth and crowns to rebuild missing dental structures.
A multistage sequence starting with provisionals to test a modified vertical dimension and centric relation, followed by the surgical stage and finalization with individual all-ceramic crowns supported by implants and natural teeth.
Provisionals were placed first, surgical events occurred while in provisionals, and definitive restorations were fabricated after healing.
A comprehensive esthetic and functional analysis was completed, including a diagnostic wax-up at the intended vertical dimension, incorporating a canine and anterior guidance occlusal scheme. Provisionals were milled at a thickness of 0.6 mm using polymethyl methacrylate (PMMA) resin, relined, and cemented. The team and patient evaluated and approved the new vertical dimension, occlusal scheme, and esthetics. All surgical procedures for dental implants and soft tissue management were completed by Dr. Castro. Upon healing, our skilled ceramist, David Li, fabricated all-ceramic crowns as follows: Zirconia monolithic for posteriors.
Diagnostic wax-up, facial scanning and esthetic analysis, teeth-supported provisional PMMA, zirconia monolithic crowns on teeth and implants, zirconia multilayered crowns on teeth and implants, occlusal night guard.
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