IMPLANT RECONSTRUCTIVE DENTISTRY

09/27/2025

Porcelain veneers are the best, most durable and conservative treatment for discolored teeth. Under the right occlusal conditions, proper material selection, and ideal cementation techniques they could be almost as durable as a full coverage restoration. This patient had maxillary veneers placed many years back. She presented with the chief complaint of; receding gums, cement line staining and incisal edge wear. Through CAD planning and IOS STL images superimposition, we developed a proposal that was shown to the patient in Exocad. These new lateral and central incisor veneers had properties that allowed us to block out the dark color of her teeth. She was able to smile with confidence again.

08/29/2025

We are proud to be at the forefront of clinical advances in implant dentistry. We are collaborating with the best craniofacial centers in Houston and Austin to be able to plan and deliver fixed prosthesis to patients that otherwise wouldn’t be able to get any teeth at all. Using the KLS Martin IPS implant system: a combination of orthognathic surgery custom plates and dental implants, we are now able to reconstruct hopeless partial of fully edentulous patients. Our model less, fully digital protocols that use stereophotogrammetry and digital intra-oral scanning, warranties precise fit and measurement of the desired fixed restoration. The following case, probably one of the first ones in the U.S., depicts the entire sequence: from the diagnostic phase, to the final prosthesis. We made an impossible case, a true reality.

07/21/2025

Placing implants prior to the completion of growth and development, poses a challenge for the restorative dentist. On this patient implants were placed at a very early age:

06/15/2025

Surgical and prosthetic complications could arise in implant dentistry, even with meticulous planning and ex*****on by dental specialists. In this case a functional mandibular fixed dental prosthesis that had been in use for 7 years, lost its far left implant, most likely due to excessive occlusal loads and parafunction. The fixed prosthesis was modified to allow the removal of the failing implant. Two more implants were placed on the lower left segment. Once these integrated, we transitioned to a 3d printed fixed prosthesis. We realized that the most distal implant couldn’t be used to its limited restorative space and cheek biting concerns. We also realized that we were really tight on site #21 as the provisional kept on breaking, even without a cantilever. It was decided to fabricate a two piece fixed prosthesis, with a titanium substructure with metal occlusals and a Zirconia suprastructure. This screw retained prosthesis minimizes the fracture risk. Being a board certified prosthodontist is not only about proper planning and positive outcomes but also knowing how to problem solve and come back from difficult situations. Another happy patient.

05/17/2025

The incidence of dentoalveolar trauma in young individuals is relatively high. This patient had trauma on one of her maxillary central incisors, that eventually needed a root canal. Consequently she had this tooth restored with a series of composites resin that were changed frequently as they fractured or got darker. She was referred to us for a definitive restoration, as the patient had recently turned 18 years old. Her case was unique as we had reduce enough tooth structure to make our lithium disilicate crown thick enough to prevent the darker color of the preparation to show through. For aesthetic cases like this one, we always capture the stump shade and ask our lab technician to see the patient for a custom shade recording. When trying in the crown, we use different shades of try- in pastes, in order match the color of the adjacent tooth the best possible. Another happy, functional patient.

04/12/2025

We had a great time at the MD Anderson Oral Oncology Symposium. Many thanks to the organizers and staff who made it possible.

We got an honorable 2nd place in the poster competition. Had fun talking to friends and colleagues about a novel fixed dental prosthesis approach for cleft lip and palate patients.

04/04/2025

03/28/2025

All on X, is not always the ideal treatment of choice.  Bar retained overdentures provide almost the same chewing efficiency of fixed dental prosthesis, with the added benefit of being able to clean the implants and the teeth more efficiently, consequently improve the implants long term prognosis. The only disadvantage is frequency of maintenance, as we have to change the plastic retention inserts at least once a year,  as they wear down. This patient’s priority was ability to clean and implant survival.  We decided to splint the implants with a bar for improve long term prognosis and do a removable prosthesis to allow for better, more efficient hygiene.  The patient is very happy with the outcome.
Another happy patient! 😊🦷

Implant Reconstructive Dentistry
___________________________
📞 713.664.9900
💻 www.implantshouston.dental/

03/21/2025

This patient fell face first onto a concrete surface. Our oral surgery colleague referred her over for a comprehensive treatment plan and for planning for interim restorations prior to removal of her fractured teeth. Through digital impressions and computer planning, we 3D printed a removable RPD and single provisional in less than 1 hour.  Implants were placed on sites 9, 10 and Fixed Dental Prosthesis was delivered.  Custom gold hue abutments were used to retained a Zirconia bridge. 
The patient was very happy about the outcome. 😇🦷🙌🏼

Implant Reconstructive Dentistry
___________________________
📞 713.664.9900
💻 www.implantshouston.dental/

02/28/2025

Stereophotogrammetry has changed dramatically the way we acquire impressions of multiple implants. Some systems have limitations that vendors don’t typically disclose until is too late. Some of them are: the need for calibration every time you do an impression, inability to impress partially edentulous patients where some teeth are kept as landmarks during the impression process (applies to all the vertical, rectangular scan body systems) and the inability to work on patients with limited opening or tight posterior inter-arch spaces.
 
In this case, we had patient with very limited restorative space where we used the MINI PIC scan bodies for multiunit abutments. This allowed us to streamline a provisional restoration, with a modelless approach,  in a 100% digital environment.  It took us only 90 minutes to fabricate and deliver, from IOS, PIC scanning to 3D print and delivery. 
Another happy, functional patient!

Implant Reconstructive Dentistry
___________________________
📞 713.664.9900
💻 www.implantshouston.dental/

02/21/2025

Cranio-facial patients with temporomandibular disorders are very challenging to manage.  This patient developed TMJ osteoarthritis after orthognathic surgery.  She ended with severe mandibular atrophy and very limited opening.  She underwent a right condylectomy with a coronoid transplant to the Right mandibular ramus.  Additionally she a had severe tongue thrust habit, extreme bruxism, poor mandibular dentition, and she had severe class III malocclusion. 
 
In coordination with the oral surgeon we phased the mandibular extractions and dental implants.  We did a hybrid plan, that included digital and conventional approaches  to fabricate her interim and definitive prostheses.  All implants were placed parallel to each other, as planned.  We used locator RT-X abutments.
 
The patient’s functionality and self-confidence was regained.  Another happy patient.

Implant Reconstructive Dentistry
___________________________
📞 713.664.9900
💻 www.implantshouston.dental/

02/14/2025

Congenitally missing teeth and peg shaped teeth is the bread and butter in our practice.  We have great orthodontic partners that allow us to participate in the planning of these cases. We discuss items such as symmetry and occlusion prior to braces removal or debonding. This improves the outcomes and makes the treatment more predictable. This patient had a Maryland Zirconia Fixed dental prosthesis with wings on the lingual of his central incisors. We generate a CAD plan in our lab and then prep the teeth and sent the case to be fabricated by one of our partner ceramist. The patient will enjoy a fixed solution for his missing teeth, until he is done with growth and development. We will plan for dental implants.  
Another happy functional patient. ✨

Implant Reconstructive Dentistry
___________________________
📞 713.664.9900
💻 www.implantshouston.dental/