Restoring balance

A missing single tooth, especially an upper incisor, can be a really big issue for a patient. There are traditional options to replace the missing tooth such as a denture, Maryland Bridge or even a fixed bridge. These all have advantages and disadvantages. A dental implant can be an ideal option if there is adequate width and height of bone.

This article will explain an alternative treatment option, which is conservative (on tooth preparation), aesthetic, and importantly a fixed option - using composite. The treatment is clinically proven with excellent long-term survival rates.

 
Standard shade guide.

Outside Special Shades.

Inside Special Shades

Case history

The patient presented with multiple upper missing teeth and a loose UR4 which had a poor prognosis and required extraction. The patient was wearing a partial upper acrylic denture and had the UL1 missing tooth on the denture. His goal was to have fixed options for the upper arch. The patient had suffered from periodontal disease, and adequate periodontal treatment was provided, as well as advice on hygiene techniques and prevention. It was decided following a thorough consultation, to consider bone grafting and implants for the posterior regions, and a direct fibre retained composite bridge for the missing central incisor tooth. The patient wanted to stop wearing the upper denture as quickly as possible. There was not adequate width of bone at UL1 and the patient did not want to have a block bone graft at this site. The other important aesthetic issue, was to not have a very long looking tooth at UL1 (the patient had a high smile line and this area would show). This meant that the careful use of pink composites would be needed to simulate the gum tissues cervically.