This patient was referred to our clinic because of its aesthetic complexity. The loss of 2 front teeth has caused shrinkage of the gums and an attempt to replace them with a conventional bridge was aesthetically unsuccessful because of the differential gum heights. We removed the bridge placed a single dental implant and reconstructed the gum volume with simultaneous bone and gum grafting. After healing we fitted a 2-unit bridge supported by the single fixture; the adjacent tooth that was replaced was a cantilever. The other natural teeth that acted as supports for the old bridge were restored with individual porcelain crowns.
1. An obvious indentation of the gum under the right central and lateral incisors.
2. A view with the bridge off showing the filed down natural teeth that supported it. Also visible is the implant in the right central incisor position. Of note is the restored thickness of the gum area under the bridge where the teeth were missing.
3. A view with the bridge off showing the filed down natural teeth that supported it. Also visible is the implant in the right central incisor position. Of note is the restored thickness of the gum area under the bridge where the teeth were missing.
4. The cantilever bridge is in place. Note the altered thickness and choreography of the gum compared to the first picture above.
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