Splitsville: Ridge Split Case with Custom Titanium Abutments

Sorry I have not posted for a while, been working on Implants Made Easy 2.0 and a product line (surgical instruments, CEREC Guide punches and keys, and a line of Periotomes.  But here is a case that is certainly not ideal, but shows how things can change during treatment plans.  Patient presented with pain and swelling around a few teeth.  Did not want implants and no matter how hard I tried  she would not have it.  So I started with carries  control.  #6 and #11 post had post perforations which I retreated  with MTA.  After a month to see what settled out, we ended up extracting 6, 11 and 4.  As I quoted for a non implant case I agreed to do the implants and custom abutments at no charge.

Really thin ridges everywhere so we did two ridge splits and planned pilots for those areas.  Re-inforced the thin buccal plate with graft and membrane.  Got some expansion, but had to place the implants fairly subcrestal.

Went for a two stage surgery due to the splits and primary closure.

Took an impression intra orally for Bio-temps which we kept her in for 6 months.  Patient returned for uncovery, In retrospect I should have done some bone recontouring in the 8-10 to even everything out.

Custom abutments from Custom Direct by Implant Direct. I just love those things.  All abutments torqued (not twerked as my patients think I say when tightening them !)

Finals with pink porcelain.  Crowns remented with Relyx resin reinforced Glass Ionomer, Implant bridge

with temp bond.  Handy Dandy floss threading trick.

Before and After, even though we had to use pink porcelain the patient has a low smile line and I think we got a good improvement.  Will work on the lowers when she is ready.