North Texas Dentistry Volume 5 Issue 5 | Page 14

SMILES SPOTLIGHT in the Treatment Decisions Restoration of the upper/lower six anterior teeth with proper anterior guidance, implants and sinus lift to replace fractured bicuspids. Crown lengthening of the upper left posterior quadrant to match the ridge height of the right side (no crown lengthening of the anteriors, only a slight increase in incisal edge position). Before Treatment The images of the “E” position and “M” position are very helpful in deciding the best approach to achieving the patients goals (Figures 1 & 2). LEADERS IN NORTH TEXAS DENTISTRY CREATING UNFORGETTABLE SMILES Implant Dentistry in the Esthetic Zone 1 Implant Dentistry Implant dentistry represents challenges that test the skills of even the best clinicians. Implants in the esthetic zone require the restorative dentist, surgeon and laboratory to be exceptional every time. A comprehensive evaluation along with x-rays, mounted diagnostic models, photos are the minimum requirements to begin to shape the plan. Being successful means that we always begin with the end in mind and develop a wax up that represents the desired outcome. Several questions always need to be answered before treatment can proceed. n n n n n n n n Are there health concerns preventing implant procedures? What is the health of the temporomandibular joint? Are there signs of occlusal disease that need to be addressed? Is the anterior guidance acceptable? Is there a repeatable treatment position? Are there any signs of periodontal or pupal infection? Are patients expectations realistic and achievable? Are finances a concern? 2 The lateral anterior photos reveal some to the wear issues and fractured incisal edges resulting in an inadequate anterior guidance (Figures 3 & 4). 3 These are the big issues that often stand in the way of a successful outcome. We must realize, only the correct information in the correct sequence creates predictable excellence. Case Presentation A 56-year old female patient presented with concerns of recently fractured upper bicuspids and generally sensitive teeth. Her goals were to have a nice smile and to prevent fractured teeth in the future. She had been told that to improve her esthetics, she would need crown lengthening in the upper anterior segment. 14 NORTH TEXAS DENTISTRY | www.northtexasdentistry.com 4