Chief Concern: Stephanie had a 20-year-old upper crown and a bridge fixed restoration that was “falling apart” due to dental decay and periodontal disease. She wanted to replace her teeth with a fixed dental implant bridge.
Treatment Received: In one surgical visit, Stephanie’s teeth were removed and her implant site development was completed with a bilateral lateral wall sinus augmentation (vertical bone reconstruction). This step was followed by eight implants twelve months later. Stephanie wore a transitional removable denture during the healing phase. The final case was a fixed bridge attached to eight implants with a night guard appliance made to protect her beautiful new smile.
Chief Concern: Arlene was rightly concerned about losing her lower right first molar (#30) due to an abscess. Her lower left implant (#18) was previously placed by Dr. Levine a few years prior.
Treatment Received: In her first surgical visit, the tooth was removed and ridge preservation was completed (bone graft, membrane, and plasma rich growth factors (PRGF) from blood drawn) to preserve the ridge in three dimensions. Three months later, site-specific CBCT imaging was taken in-office to finalize implant position and length in relation to the mandibular nerve. A surgical guide was fabricated, the implant was placed, and the case was completed by Arlene’s restorative dentist eight weeks later.
Chief Concern: Judy’s #4 tooth was broken and was not restorable on a previously crowned and root-canaled tooth.
Treatment Received: In one surgical visit, we extracted #4, and site specific sinus bone augmentation (osteotome procedure) was done with a single dental implant placement. The porcelain crown on the tooth was completed five months later.
Chief Concern: Audrey came in with two, failing, endodontically treated, maxillary central incisor teeth (#8, 9). She was very unhappy with her smile and was unable to bite on these teeth due to discomfort and tooth mobility.
Treatment Received: The two failing teeth were removed and implant site development was completed with hard and soft tissue augmentation. Single implants were placed three months later followed eight weeks later by fixed provisional crowns for tissue sculpting, followed by her final single crowns. At time of this writing, Audrey’s orthodontic therapy in her lower jaw is nearing completion to allow the placement of single implants in her first molar areas.
Chief Concern: With a history of gum abscesses, periodontal surgery and diabetes, Simon came in with general concerns about his back teeth.
Treatment Received: Simon’s upper arch received bilateral lateral wall sinus bone augmentation procedures followed by individual implants in his back posterior areas. His lower right failing bridgework was replaced with two immediate implants and restored as single units along with a single pre-molar in his lower left.
Chief Concern: Upon orthodontic completion to replace her upper left canine tooth (#11), Barbara was interested in a single crown and thus desired replacement with a dental implant.
Treatment Received: Moderate ridge atrophy was noted at the time of implant placement which was completed with bone grafting and utilization of the hard and soft tissue benefits of Gem-21®. A resorbable collagen membrane was used to aid in bone reconstruction. The final crown was completed 7 months later.
See Dr. Levine’s article published on this case: Present, S., Levine, R.A. “Single Maxillary Anterior Tooth Restoration,” Inside Dentistry. 2010
Chief Complaint: Amy had experienced a traumatic accident resulting in the loss of five maxillary teeth (#9 thru 12) and severe bone loss in three dimensions requiring extensive bone reconstruction surgery.
Treatment Received: Due to her extensive vertical and horizontal bone loss, a large bone reconstructive procedure was completed for site development using bone graft, GEM-21® and titanium mesh. A provisional restoration was used prior to completion with the final restoration being a fixed bridge #8-12 with implants sites #8, #10 and #12. Pink porcelain gingiva was used to match her existing soft tissues.
Chief Concern: Jack had been under our care for 15 years. We were maintaining his teeth as best as possible, with very advanced periodontitis in his upper arch. Prior to retiring from his job, he wanted to permanently solve these problems.
Treatment Received: In a “staged” approach, a lateral wall sinus bone augmentation procedure was completed keeping his upper right hopeless teeth in place so as to be without these teeth a minimal amount of time. Twelve months later, Jack’s upper right molars and premolars were removed (#’s 2 thru 5). Four individual implants were restored in his upper right. The single upper left molar required a site-specific sinus augmentation (osteotome) and was restored as a single crown.
Chief Concern: Tatiana was very unhappy with her smile due to advanced periodontal disease. All her remaining teeth were loose and she had difficulty chewing with an upper removable partial denture.
Treatment Received: Due to significant bone atrophy in three dimensions in all quadrants of Tatiana’s mouth, vertical (bilateral sinus augmentations) and horizontal bone reconstruction was completed with titanium mesh and bone grafting with plasma-rich growth factors (PRGF) after removal of all teeth. Eight implants were then placed in the upper and six implants in the lower for fixed bridgework on custom zirconium abutments. The upper case was completed in five sections and the lower case in two sections. A night guard was made to protect her lovely, new porcelain restorations.
Chief Concern: Yvonne was unhappy with her smile. She knew her upper front implant bridge (placed over 15 years prior by another surgeon) was failing due to advanced periodontal disease.
Treatment Received: After removal of Yvonne’s remaining upper teeth and failed implants, bone reconstruction was completed using titanium mesh, bone graft and plasma rich growth factors (PRGF). Four implants were placed six months later and her case was completed with a patient removable bar splint overdenture with locators.
Chief Concern: Max was unhappy with his smile, had loose teeth and generalized, advanced periodontitis.
Treatment Received: In one surgical visit, all of Max’s remaining teeth were removed with placement of six implants in his lower arch with the SameDay Smile® concept. Ridge preservation was completed in the upper jaw with bone grafting to preserve remaining bone contours. Bilateral lateral wall sinus augmentations were completed in the upper jaw eight months later followed by eight dental implants. Max’s case was completed with a framework-reinforced, doctor removable hybrid restoration in both arches.