message board Anterior Adjacent Implants A Townie's struggle with a result leads other dentists to share advice and similar cases DrillaNvanilla Member Since: 11/28/18 Post: 1 of 33 Good morning, docs! I have a case I'm working on and would love to hear everyone's thoughts/advice. A 55-year-old female patient presented to the clinic with mobile #7, #8. Referral to a periodontist. Decided to extract, bone graft and implants (Zeramex). The patient returned to the offi ce for restorations (see photos). The implant collar on #8 is slightly visible supra-g. I took impressions and sent them off to the lab to get a better idea of what it may look like in the end. Abutments placed and crowns placed. Asked the patient what her thoughts were and then shared mine. The crowns look great (need minor shade adjustment). No papilla and abutment were more visible than I hoped. The defects are not in the smile line and would have to displace the lips to really identify the black triangle and defect. The patient was ready to be done with all this-understandably so-but I mentioned the outcome is not what I had imagined. I've reached out to the lab to discuss options and I will also reach out to the periodontist soon. I just would like anyone's expert advice/opinions on this case and how to make it the best possible outcome for this patient. Thank you. ■ 3/9/2022 shpinatlanta Member Since: 02/19/06 Post: 2 of 33 From my own experience, it's just about impossible to get symmetry in cases like this. With these two implants side by side, it will be diffi cult to get a good outcome without some pink porcelain. In this case, it is hard to tell what the fi nal bone graft looked like before implant placement. You defi nitely need as much bone as you can get. What I do is usually place one implant and cantilever the lateral pontic. Here's a similar case: Cracked root #8, had to be extracted. 32 JANUARY 2023 // dentaltown.comhttp://www.dentaltown.com