05/05/2026
Semi complicated case with many moving parts.
1. Patient had an impacted canine that could not be brought down with orthodontics.
2. That canine tooth had to be extracted and it was a very tough surgery for both the surgeon and patient.
3. Implant placed by oral surgeon months after surgery.
This is when the patient showed up in my office. She was at the end of ortho, implant had been placed by an oral surgeon and Dr. Chris Fogarty sent her to me with a couple things in mind:
1. She would be getting her final restoration for her implant at my office.
2. When he wrapped up her ortho, she needed something in the missing canine area because the implant was not ready to be restored.
3. The MOST IMPORTANT: this is in the esthetic zone and Dr Fogarty and I were both wanting the tissue to look normal and healthy and match. Sometimes tough to do with implants.
What doesn’t work, is anything removable. It will not allow the tissue to adapt and you end up with flat tissue that does not look normal when restoring with an implant crown.
What does work is something fixed and in this case a fixed but temporary Maryland bridge.
I flapped open the tissue exposing the top of the implant as if I was doing an implant uncovery, then cemented the Maryland bridge in place and then sutured the tissue lightly back in place and allowed it to rest on the temp tooth. This is how you manage tissue in the esthetic zone.
This photo is almost a month out post op and the tissue looks great, healthy and very natural. This will allow my lab to create a very nice and matching implant crown when that time comes.
Kudos to Oral Arts Lab for making a stellar temp Maryland bridge for my patient.
