There are two implants in these pictures, #8 and #12. The central incisor looks like a restored implant. The premolar looks like a tooth.
I restored both implants and in fact, they are in the same mouth. I had the opportunity to have a detailed discussion with the periodontist who placed the premolar implant prior to making any final treatment decisions. The patient came to me with the central incisor implant already in place. He lost a tooth and the surgeon placed the implant and then told him to go have a crown made.
Don’t get me wrong, I am not placing blame; I don’t know the story from the surgeon’s side. I only see the final result. Yet, this is an excellent illustration that creating great working relationships with specialists can make a huge difference in the outcomes of cases.
When we did the implant in the premolar region, the surgeon had a surgical guide that I created so that he knew exactly where the implant needed to be so that I could restore it well. He asked me to show him exactly where I wanted the final tissue contours and then had me make the surgical guide to reflect that tissue position.
We talked about timing and how the provisional would be made. Those conversations only take a few minutes, and they often mean the difference between good and excellent results.
The restorations look different because the premolar implant was placed deep enough and in the correct labiolingual position so that the tissue could be sculpted to mimic the cervical contours of the natural tooth. The central implant was placed much too far labial and with little room to develop emergence profile.
The results speak for themselves.
