Managing esthetic implant complications.

Dental implant success today is judged not only by osseointegration but also by esthetic results. Cosmetic predictability can often be difficult to attain, and esthetic implant failures can be multifactorial. Once esthetic implant failures occur, many cannot be fully corrected. Some complications must be addressed by an interdisciplinary dental team. In this summary of case reports, surgical considerations are provided, including cases of facial asymmetry/recession due to facial implant placement or bone loss resulting from technique/treatment failures, as well as papillary deficiencies. Restorative considerations for correcting failures are also discussed.

Managing congenitally missing lateral incisors. Part III: single-tooth implants.

UNLABELLED: Three treatment options exist for the replacement of congenitally missing lateral incisors. They include canine substitution, a tooth-supported restoration, and a single-tooth implant. Selecting the appropriate treatment option depends on the malocclusion, anterior relationship, specific space requirements, and condition of the adjacent teeth. The ideal treatment is the most conservative option that satisfies individual esthetic and functional requirements. Today, the single-tooth implant has become one of the most common treatment alternatives for the replacement of missing teeth. This article closely examines the many interdisciplinary issues that arise when treatment planning the placement of single-tooth implants in patients with congenitally missing lateral incisors. The specific criteria that must be evaluated illustrate the importance of an interdisciplinary treatment approach to achieve optimal esthetics and long-term predictability. This is the final article of a three-part series discussing the three treatment alternatives for replacing congenitally missing lateral incisors. CLINICAL SIGNIFICANCE: When treatment planning single-tooth implants to replace congenitally missing lateral incisors, an interdisciplinary approach is necessary to provide the most predictable treatment outcome.

Managing congenitally missing lateral incisors. Part II: tooth-supported restorations.

Three treatment options exist for the replacement of congenitally missing lateral incisors: canine substitution, a tooth-supported restoration, or a single-tooth implant. Selecting the appropriate treatment option depends on the malocclusion, the anterior relationship, specific space requirements, and the condition of the adjacent teeth. The ideal treatment is the most conservative alternative that satisfies individual esthetic and functional requirements. This article closely examines the three options when replacing a missing lateral incisor with a tooth-supported restoration. These options are a resin-bonded fixed partial denture, a cantilevered fixed partial denture, and a conventional full-coverage fixed partial denture. The specific criteria that must be evaluated for each option is addressed to illustrate the importance of interdisciplinary treatment planning to achieve optimal esthetics and long-term predictability. This article is the second of a three-part series discussing the three treatment alternatives for replacing congenitally missing lateral incisors.

Managing congenitally missing lateral incisors. Part I: Canine substitution.

UNLABELLED: Dentists often encounter patients with missing or malformed teeth. The maxillary lateral incisor is the second most common congenitally absent tooth. There are three treatment options that exist for replacing missing lateral incisors. They include canine substitution, a tooth-supported restoration, or a single-tooth implant. Selecting the appropriate option depends on the malocclusion, specific space requirements, tooth-size relationship, and size and shape of the canine. The ideal treatment is the most conservative option that satisfies individual esthetic and functional requirements. Often the ideal option is canine substitution. Although the orthodontist positions the canine in the most esthetic and functional location, the restorative dentist often needs to place a porcelain veneer or crown to re-create normal lateral incisor shape and color. This article closely examines patient selection and illustrates the importance of interdisciplinary treatment planning to achieve optimal esthetics. It is the first in a three-part series discussing the three treatment alternatives for replacing missing lateral incisors. CLINICAL SIGNIFICANCE: Patients with congenitally missing lateral incisors often raise difficult treatment planning issues. Therefore, to produce the most predictable esthetic results, it is important to choose the treatment that will best address the initial diagnosis. This article is the first in a three-part series that describes the different treatments available for patients with congenitally missing lateral incisors. This first article focuses on canine substitution as a method of tooth replacement for these missing teeth. The general dentist will learn to evaluate specific patient selection criteria and determine whether canine substitution is an appropriate treatment alternative for replacing missing lateral incisors. The orthodontist will understand how to position the canines to satisfy functional requirements and achieve proper esthetics. Finally, the importance of interdisciplinary team treatment planning is emphasized as a requirement for achieving optimal final esthetics.