Gary had a couple of crowns placed in the front region a few years ago at another practice. Unfortunately, one of them was displaced prematurely, as there was not much tooth to support the post-crown. This is not an uncommon event. To remake the crown would have entailed a small surgery to expose more root structure, and thus a longer crown. As this involves the removal of some bone and gum tissues, future implant treatment may be compromised. Furthermore, the alignment of the gum margins would be uneven. Thus, Gary elected to have the remaining root of this tooth removed and an implant placed.

As there had been some bone loss, simultaneous bone grafting was carried out during the placement of the implant. After the implant had fused, further augmentation of the gum tissues was carried out with a minor gum transfer. Then, when the gums around the implant site had matured, an intermediate crown was made. This step is not always necessary, but when implant treatment is at the front of the mouth, this can be beneficial as the surrounding gum tissues can be guided to heal in a natural shape. This will help the overall result look most natural. A ceramic bonded crown was finally made with a screw-retained design for ease in future servicing.