This case highlights very well the difficulties faced when patients wait for a long time after tooth removal until dental implant placement.
It followed a surgical removal of an ectopic eye tooth or canine.
The surgery on the palate left the remaining bone misshapen. As this impacts on the gum position around a dental implant, aesthetics were consequently more challenging.
The gum position becomes hard to manage as can be seen from the higher gum on the incisor just in front of the implant – the darker tooth.
We can see on the impression and mirror plan view that the implant position lies a little further towards the outside which causes the gum to lift a little higher.
The patient and technician discussed shading at length due to the darkness of the adjacent lateral incisor. We decided to match shading to the central incisors (front two) with a view to potential porcelain veneer on the lateral incisor at a later date.
The patient didn’t wait too long before embarking on the final stage of his cosmetic dentistry voyage. The final results looked fairly good, considering the challenges faced with respect to the adjacent tooth shading, history of surgery and gum position.