29/05/2026
let’s break this case down starting with the problem list:
Missing teeth from trauma, no bone for conventional implants, span too long for a bridge, patient wearing a denture ❌
Collapsed bite, over erupted teeth, crossbite
Gummy smile, irregular gum levels, huge bone and soft tissue defect
Teeth - worn, chipped, disproportioned, misaligned, aesthetically demanding.
What discipline’s needs to be involved ?
Restorative / prosthodontics - myself, leading the treatment plan and the design stages start to finish starting with the end in mind. Starts with trial smile - bite, aesthetics, function, defect resolution etc.
Periodontics - crown lengthening to balance the gum heights / gummy smiles following the smile design plan.
Oral surgery - bone easy sub periosteal implant placed, design of fixed implant emergence following smile design plan ready for aesthetic prosthodontic solution
Stabilisation and lower composite build ups, following the new occlusal plan fully guided by injection mould technique giving predictable aesthetics and suitable function.
Appointment sequences :
1. Data acquisition and planning. 3D face scanning, CBCT, IO Scans, photos, video and CR records.
2. Mock up trial smile and communication into all disciplines to follow the agreed plan.
3. Surgical Crown lengthening .perio
4. Lower composite build ups and upper crown preps ready for stabilisation phase in desired position - upper printed temps lower composite build ups.
Same day quadrant dentistry with Midas 3D printed onlays
5. Oral surgery - subperiosteal implant
6. Final restorative phase upper zirconia restorations with pink aesthetics.
All following workflows it’s as easy as 1,2,3