My special thanks to Dr. Stephen Francis of Martinez, CA for his help with this Case of the Month. The clinician faces many challenges when treating cases where there are two adjacent implants, in the esthetic zone. This patient also has a very high smile line and demanding esthetic requirements. Implant placement was was via computer guided techniques to facilitate the most accurate surgical placement. Dr. Francis was meticulous with his prosthetic techniques and obtained an outstanding result with this patient.

1. Esthetic zone case / high smile line case with adjacent teeth with root resorption

2. My special thanks to Dr. Stephen Francis of
Martinez, CA for his help with this Case of the
Month. The clinician faces many challenges when
treating cases where there are two adjacent
implants, in the esthetic zone. This patient also has
a very high smile line and demanding esthetic
requirements. Implant placement was was via
computer guided techniques to facilitate the most
accurate surgical placement. Dr. Francis was
meticulous with his prosthetic techniques and
obtained an outstanding result with this patient.

5. LIZANO IMPLANT DENTISTRY

6. 42 y.o. female
Findings: with high
smile line
Internal
History of
resorption #10
gingival
(poor
grafting upper
prognosis per
bicuspid areas
endodontist)
Severe
Medical
external
history
resorption #11
unremarkable
– unrestorable
Moderate to
Cuspid severe
guidance angulation to
disclusion anterior
maxilla
LIZANO IMPLANT DENTISTRY

7. Alternatives
No treatment
Extraction
Fixed bridge
Removable appliance
Endodontic treatment (poor prognosis)
Implant supported restoration to replace
missing teeth.
Possible orthodontics or additional restorations
needed to provide implant protected occlusion
LIZANO IMPLANT DENTISTRY

8. Treatment Plan
Ridge CBCT scan and
Temporization: computer based Restoration of
preservation
Extraction of treatment plan Implants #10 and implants (and
grafting (allograft) Essix, Tx RPD or
teeth #10 and 11 and surgical guide 11 sites adjacent teeth as
Bonded ? needed)
LIZANO IMPLANT DENTISTRY

9. Atraumatic Puros 4 Month
Extraction allograft healing
LIZANO IMPLANT DENTISTRY

10. Facilitate Surgical Planning
LIZANO IMPLANT DENTISTRY

11. Facilitate Surgical Planning
LIZANO IMPLANT DENTISTRY

12. Facilitate Computer Based Treatment Plan
LIZANO IMPLANT DENTISTRY

13. Facilitate Surgical Planning
LIZANO IMPLANT DENTISTRY

14. LIZANO IMPLANT DENTISTRY

20. 1 year after implant placement

21. Two years after restoration

22. Two years after restoration

23. 3 years after implant placement

24. Three years after implant placement