Laterals Gone Wild
Personality plus is the only way to describe Brian. This young Father appointed with the singular focus to improve his smile. Not for him, but for his wife and young kids. He was tired of being made fun of and was finally ready to tackle these unflattering lateral incisors.
He can’t even remember how long he’s had these restorations. I can’t imagine how long someone could look at themselves in the mirror each morning and think that this was a “look” was acceptable. Never the less, Brian was ready for a change.
The existing Maryland Wing bridges could not have originally be fabricated with the laterals so angulated and out of the alignment. I couldn’t imagine what could have caused these restorations to migrate into these positions over the years. Without understand the how and why, we pushed forward with a plan to reconstruct proper contours of the laterals with either new Maryland Wing bridges or Cantilever bridges.
Due to the asymmetry of the centrals and the mesio-distal spacing for each lateral incisor, we agreed to prepare the centrals for bridge abutments and cantilever the lateral on each side. This allowed us the greatest opportunity to control the esthetic outcome.
Both centrals were prepared for full coverage crowns. The case was designed using BioIndividual, Biojaw was used to create the final proposals. A 4 unit milled TelioCad bridge was fabricated has a provisional for the patient. The temporary was also used as a template for the final contours. Printed models from Infinident were ordered. These can be very helpful during the final shaping, texturing and the stain/glazing of the final eMax bridges.
After the patient approved the restorations, the bridges were bonded with Ivoclar’s Esthetic Cement protocol.
The patient was very pleased with the final results, giving him a new found confidence and smile he could be proud of. His children will now need to find something new about Dad to make fun of!!
Patient not interested in implant therapy. Although it was discussed, patient was most interested in a quick fix. The time and potential expense for implant retained restorations was a definitive no. I respected his decision.
Nice case to present Steve. Thanks for sharing!
Some minor ortho on the centrals weren't an option to help with the final esthetics? I just posted a case where the patient refused, but nice to see it written in the presentation if that was so just we know it was discussed when appropriate.
What is the occlusion on protrusion and excursives look like on those laterals? Could that be the culprit to moving the original pontics or how they wound up being shaped?
Great service and lovely job all around Steve. What an upgrade and I"m sure you'll get nothing but positive feedback from every angle on this!
Ernie-No doubt ortho could have helped the midline and the spacing. Not sure that protrusive interferences would be the basis for the migration of the teeth. If so, I would have expected the original bridges to fracture or debond at some point. The wings were secure with no signs of fatigue or loosening. As I stated previously, patient was not interested in a lengthy treatment plan. Point well taken about laying out ALL of the treatment options for the group.
Daniel-Case was completed prior to getting our digital printer:)
