Case History
When Mr TR came to see me he had fractured his upper left central incisor in an accident many years ago. He is a mechanic and whilst working under a lorry a spanner had fallen down and hit him in the mouth! The subsequent post crown had fractured and been extracted about a year before. He found the immediate denture intolerable and a Maryland Bridge lasted six months without incident, but then fell off five times in the next six months. He had researched implants himself and his dentist referred him to me. He felt the fee of £2000 was reasonable for the benefit the implant would give him.
The initial consultation confirmed via medical history, clinical examination, and X-rays that he would be suitable for an implant and the site was satisfactory with ample bone. He had only one other missing tooth, an upper left second premolar that did not show and had been missing for many years. His oral hygiene was good. The full procedure was explained to him and it was decided that we would aim to place the fixture and a temporary crown in one stage as he was embarrassed by the gap. He declined IV sedation.
At the surgical stage a 15mm regular platform Branemark implant was placed and a temporary acrylic crown made using a temporary cylinder and a Directa crown form. The acrylic that was to be sub-gingival was contoured and polished to begin the process of moulding the soft tissue during the healing stage to ensure a satisfactory margin and natural appearance. The temporary crown was then screwed to the implant.
When the sutures were removed the stability was excellent and the temporary crown survived the rigours of Christmas the next week! The temporary crown was left in situ for 2 — 3 months until integration was complete and the soft tissue had been moulded to give a natural appearance. The final crown was fitted and Mr TR was a very happy man!
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