Dr. Constantine Stavrinoudis DDS, FACP

Dr. Constantine Stavrinoudis DDS, FACP Board Certified Prosthodontist specialist who has advance training in comprehensive complex full mou

Digital Precision. Biomechanical Fundamentals.The continued evolution of digital dentistry has significantly enhanced ou...
08/28/2026

Digital Precision. Biomechanical Fundamentals.

The continued evolution of digital dentistry has significantly enhanced our precision in planning, designing, and delivering full-arch implant prosthetics. From digital scanning and photogrammetry to CAD/CAM, milled frameworks, and zirconia, these technologies have transformed what we are able to accomplish.

But greater precision does not make the fundamentals any less important.

A recent debonding was a reminder that the complication itself may only be part of the story. Throughout a digital workflow, there should be deliberate checkpoints where we evaluate and respect the biomechanics behind the restoration.

Do we have adequate restorative space? Is the bar sufficiently tall and rigid? Are implant distribution, span length, connector dimensions, and cantilevers appropriate? Is passive fit verified? How is the prosthesis being loaded? And in the mandible, should mandibular flexure be considered as part of the mechanical environment?

These are principles that existed before the digital workflow, and they remain just as relevant within it.

Digital technology gives us extraordinary tools to improve precision, planning, and ex*****on. The opportunity is to combine those advancements with the fundamentals of prosthodontic engineering and to maintain the appropriate checkpoints from initial design through final delivery.

Embrace the technology. Respect the fundamentals. Verify the design.

Planning Before PlacementWhen patients hear “two teeth extracted and two implants placed,” the procedure may sound strai...
08/24/2026

Planning Before Placement

When patients hear “two teeth extracted and two implants placed,” the procedure may sound straightforward. But with adjacent teeth, especially in the smile zone, the planning and sequence are just as important as the implants themselves.

This case reflects a prosthodontic approach. Treatment is planned backward from the desired final restoration. Implant positioning, surgical sequence, provisionalization, soft tissue management, abutment selection, shade, and final design are considered before treatment begins. A predictable result also requires close collaboration among the restorative dentist, surgeon, and laboratory technician.

Each tooth was carefully extracted one at a time using a flapless approach, followed by immediate implant placement and a copy milled provisional restoration. The objective was not simply to replace the teeth, but to preserve the existing architecture, particularly the papilla between the implants and the surrounding tissue. The implants were then allowed to fully osseointegrate before the definitive restorative phase.

Many important details are things patients may never see. Implant position, the distance between implants, emergence profile, and adequate “running room” all influence the final result.

Abutment selection is equally important. A custom metal base abutment and a Ti base design with a zirconia substructure each offer benefits and limitations. The decision must balance esthetics, tissue thickness, available restorative space, and long term mechanical stability.

Shade matching required more than selecting a single shade tab because the adjacent teeth had different shades and existing restorations. Detailed clinical photography and technology such as OptiShade helped us communicate the surrounding colors accurately to the laboratory.

The patient sees the final restoration, but the result begins much earlier. It starts with careful planning, from extraction and implant placement through tissue preservation, provisionalization, abutment selection, shade, and final design.

The final restoration is what we see. The result begins with the plan.

The patient presented to me with advanced periodontal disease and severe bone loss. The condition had progressed to the ...
08/17/2026

The patient presented to me with advanced periodontal disease and severe bone loss. The condition had progressed to the point that posterior teeth were being lost almost every week, significantly compromising the ability to chew and function.

Many of the remaining teeth were also compromised by failing root canals and inadequate crowns and bridges. Due to the extensive loss of supporting bone, this case required a carefully coordinated surgical and restorative approach.

Using digital planning and guided implant surgery, conventional and zygomatic implants were strategically placed to provide stable support where traditional implant treatment alone was not possible.

The rehabilitation was completed with full arch monolithic zirconia prostheses, restoring function, bite, facial support, and confidence with a strong and natural looking result.

Complex cases require more than simply replacing teeth. They demand meticulous planning, interdisciplinary collaboration, and a thorough understanding of both surgical and prosthetic principles.

challenging and conservative smile transformation. ✨The patient was unhappy with two bulky upper central-incisor restora...
08/13/2026

challenging and conservative smile transformation. ✨

The patient was unhappy with two bulky upper central-incisor restorations that appeared overly prominent and disrupted the harmony of the smile. Treatment began with KöR whitening, followed by replacement of the two restorations with PFZ veneers.

The challenge was to improve only the central incisors, without touching the adjacent teeth while respecting the existing natural misalignment and gray undertones. Careful changes to the contours, proportions, and position brought the new restorations into better harmony with the smile arc for a softer, more natural result.

Conservative dentistry, thoughtfully planned.

Team ceramics 🎨:

When teeth are missing from birth, every millimeter matters.This patient was born without lower teeth (congenitally miss...
06/25/2026

When teeth are missing from birth, every millimeter matters.

This patient was born without lower teeth (congenitally missing teeth), creating a challenging situation where the available space was too narrow for conventional implant placement.

Through careful great interdisciplinary planning, orthodontic treatment was first used to precisely move the surrounding teeth and create the ideal space. Once the proper dimensions were achieved, narrow-diameter dental implants were placed using the precision of YOMI® robotic-assisted implant guidance, allowing for accurate, minimally invasive implant positioning.

The final restorations were then carefully designed blend into the patient’s natural smile, restoring both function and esthetics.

Every successful implant case starts long before surgery. Thoughtful planning, orthodontics, digital technology, and prosthodontic expertise make all the difference.

Great collaboration with Dr Melena Planzos Taka Tohyama Dr Melena Planzos

Hypodontia NarrowImplants DigitalDentistry SmileRehabilitation ImplantDentistry EstheticDentistry InterdisciplinaryDentistry Orthodontics FullMouthRehabilitation UpperEastSideDentist NYCDentist

Thriving to aim for perfection can be a challenging while replacing natural tooth in the front teeth. Above is surgicall...
04/16/2026

Thriving to aim for perfection can be a challenging while replacing natural tooth in the front teeth. Above is surgically placed implant that allowed us to go with a screw retained implant crown. Impression coping was modified with GC Resin to capture the soft tissue emergence profile from the provisonal. Variables always include the depth and the thickness and type of soft tissue, location of tooth and its neighboring teeth details in hope to choose what restorative materials, contour, shape to make it as natural as possible.

Rebuilding the Smile with function, Restoring Confidence!!This patient came in with severe periodontal disease and loose...
04/02/2026

Rebuilding the Smile with function, Restoring Confidence!!

This patient came in with severe periodontal disease and loose teeth and bridges that could no longer be saved.

We replaced both the upper and lower teeth with implant-supported zirconia bridges, giving them a strong, stable occlusion, and age appropriate natural-looking smile.

Keeping it simple with 6 front natural looking Veneers.This case focused on replacing defective veneers on the lateral i...
03/29/2026

Keeping it simple with 6 front natural looking Veneers.

This case focused on replacing defective veneers on the lateral incisors while preserving the natural shape and character of the central teeth. By extending treatment to the canines, we were able to subtly broaden the smile line and create a more balanced, fuller appearance.

Refining the details without changing what already works!

Ceramist 👏🏼

This case was about more than just esthetics, it was about restoring FUNCTION.The patient presented with:• Severely comp...
03/19/2026

This case was about more than just esthetics, it was about restoring FUNCTION.

The patient presented with:
• Severely compromised posterior dentition
• Advanced periodontal breakdown
• Extruded teeth creating a significant ascending ramp occlusion
• Lower posterior exostoses adding complexity to the surgical and restorative phases

Our approach focused on a comprehensive reset of the occlusion with multiple implant supported prostheses.

Treatment included:
• Removal of non-restorable upper dentition
• Extraction of periodontally compromised lower posterior teeth
• Careful preservation of the lower anterior segment, as per patient preference
• Strategic planning to re-establish proper posterior support and occlusal harmony

By eliminating the pathologic occlusion and rebuilding posterior function, we were able to create a stable, balanced, and functional bite, while achieving a natural, confident smile.

Biology, function, and esthetics align.

From Failing Dentition to Functional Beauty!!A full arch transformation. Where precision meets artistry.In this case, we...
10/07/2025

From Failing Dentition to Functional Beauty!!

A full arch transformation. Where precision meets artistry.

In this case, we planned staged extractions with strategically placed implants to maintain soft tissue support, preserve our reference points, and ensure occlusal stability throughout treatment.

All extraction sites were bone grafted to optimize future implant integration and tissue contour.

Not every case qualifies for an FP1 design, but the staged approach in this case allowed us to maintain the soft tissue architecture and meet the ideal criteria for an FP1 prosthesis.

The final result a beautifully natural full-arch Zirconia prosthesis over multi-unit abutments, delivering seamless esthetics and function. Natural Vibrant Smile!!!

Great collaboration with Periodontist and Ceramist

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139 E 63rd Street
Manhattan, NY
10065

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Tuesday 8am - 4pm
Wednesday 10am - 6pm
Thursday 10am - 6pm
Saturday 8am - 1pm

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