Patient with failing restorations treated in Georgia Prosthodontics

Case of a Patient With Failing Restorations

Do You Have a Patient With Failing Restorations?

CASE SUMMARY: The Single Anterior Implant Challenge

by Carlos Castro, DDS, FACP, Board Certified Prosthodontist | Georgia Prosthodontics

Patient “Mary” was referred to me by another dental professional in the area to improve the esthetics of an implant crown in the anterior segment. She was experiencing a recession of buccal tissue, which was leaving the implant body exposed.
An examination and a Cone Beam Computerized Tomographic (CBCT) scan revealed absence of buccal bone plate and implant angulation exceeding the limits of the occlusal area.

As a Prosthodontist, I have experience with complex cases and can plan multi-stage treatments that coordinate with a patient’s general dentist and other dental specialists. I am also comfortable treating patients with high esthetic demands. Mary felt comfortable knowing that I have experience with complicated dental issues, and have developed protocols to ensure the highest esthetic and functional outcome for the restorations.

Single Anterior Implant Challenge

Mary’s treatment included the following steps

Removed the implant and allowed the soft tissue to grow.

  • Grafted the site and allowed for proper healing.
  • A provisional was fabricated and retained from #8.
  • A new implant was placed in a better orientation.
  • Upon completion of healing time, a new provisional was used to contour the tissue, and a final impression analog was taken for screw-retained zirconia crown #9, and zirconia crown #8.
  • Final crowns were inserted, and access holes closed.

This case was challenging because of these 5 items

  1. Mary had a high smile line.
  2. High esthetic expectations.
  3. Risk of bone loss from the surgery.
  4. Keeping the margins at equal height and symmetrical.
  5. Preventing future recurrence of tissue, so enough bone on buccal of implant had to be maintained.

For any implant case, especially one involving grafting, I advise allowing growth of soft tissue, letting one miracle happen at the time, and provisionalizing to envision the final outcome.

Do you have a patient in Mary’s situation? Or another challenging implant case?

If you have a question about a case and want another opinion, give our office a call. Or, if there’s
a case that you want to work together on, please fill out and send in the enclosed referral form.
We will take great care of your patient and keep you informed. Dental professionals refer to us because we perform complex cases every day.

For additional information, please visit our website

Study Club In Prosthodontics
New Findings & Best Practices for Cosmetic & Restorative Dentistry

Do you want another opinion on a complex case? Or to meet and share ideas?

There are many ways we can help each other by working together on complex cases and by sharing knowledge and experience.
With your reputation for quality dental care and our experience with restorative treatments, we can work together on advanced cases and both benefit!
If you’d like to meet to discuss a difficult procedure or talk on the phone about how we can help each other, please call or email our office with specific days and times when you are available to talk or meet.

Registration for future events visit us at STUDY CLUB

The Reconstructive Dentistry Team

Georgia Prosthodontics is focused on Implant, Cosmetic, and Reconstructive Dentistry. Drs. Carlos Castro & Norberto Delgado have the training and private practice experience that makes treatments of complex cases more successful, including patients:

• With severely worn/damaged teeth, missing all teeth, or with ill-fitting dentures can receive a full arch of natural-looking teeth to restore function & esthetics.

Congenital defects, a chronic condition, or traumatic injury can receive oral prostheses, which may be a combination of dental implants, crowns, bridges, or veneers.

• Patients with difficult anterior cases in the esthetic zone can receive single or multiple dental implants to replace missing teeth, or veneers or crowns to improve the appearance of their smile.

In addition, they have a private dental laboratory called Prostho Dental Lab. An in-house, experienced, and certified dental technician creates each custom restoration for referred patients from the best materials using the latest technology. To send an implant case to our dental lab, please visit:

Carlos Castro DDS Georgia Prosthodontics
Dr. Carlos Castro is the only Board Certified Prosthodontist cross trained in Dental Implant Surgery

Online Referral Form

Dear Doctor:

We appreciate your confidence in us. To refer one of your patients to a Prosthodontist you can either download our referral form or fill it out online and send it directly to us.

We look forward to hearing from you!