15/04/2026
Challenging full mouth rehabilitation. We used surgical crown lengthening to provide adequate ferrule on the upper anterior teeth, porcelain crowns, an anterior porcelain bridge, and dental implants (all immediates). I was happy with the final result in improving the occlusal relationship to restore bite stability and function. However, some challenges we faced along the way included: 24 immediate implant position was not ideal (influenced by original root position), so i replaced this implant 6 months post-op - there was volume loss on the buccal aspect from the double surgery; we performed a coronally advanced flap to improve the 41 recession which failed - failure was likely due to a combination of smoking + inadequate periosteal release (he didn’t want to try a second time); the 12 decorated during the temporary phase due to little to no ferrule and was extracted at the time of insert of the final bridge for efficiency, with resultant buccal volume loss. The photos displayed are at the 1 year mark, and gingival health is not perfect but also not terrible. In correcting the Class III relationship, we were limited by the patient’s underlying skeletal relationship - this meant incisal contacts closer to the incisal edge and alterations to lingual anatomy by to account for this (plateau on the incisal third to create stable centric stop, immediate posterior disclusion from that point in protrusion). We established stable canine guidance in lateral excursions.
⚠️ Important information:
• This post provides general information only and is not a substitute for personal dental advice.
• Individual results vary. The outcome shown is specific to this patient and may not be representative of other cases.
• Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.
• Risks - azuredental.com.au
