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Before and After 2020: Missing Tooth Replacement on Lateral Incisors (Part 2)

A Caucasian male patient in his youth was introduced to me upon a failure of the previous Maryland-Bridges on 13-11, 21-23. The restorations only lasted for a few months (done by another technician), and I couldn’t identify its cause or never given a specific reason by the treating clinician.   In part 1 of the ‘missing tooth replacement’ (click here to read), I presented implant restorations in Zirconia with Ti interface abutment to replace the lateral incisors. For this case, I present more of a conservative and cost-effective option – Maryland-Bridges in lithium disilicate (e.max) for optimum bonding strength.   Figs 1-2 show the pre-op condition.   Fig 3 shows my standard protocol in shade taking. I make sure to use three different shade guides to identify the...

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Before and After 2010: Treatment of Cleft Lip and Palate – a “Pro-bono” Smile Makeover

A female patient in her early 20s presented with congenitally missing upper lateral incisors, and one canine, a total of 3 teeth seeking a fixed replacement. The patient has a cleft lip and palate bilaterally, which has been treated several times over the years with surgery to repair it. Implants are not possible as there is no bone in the surgical repair sites, and in fact, she still has an oro-nasal communication.   The patient had limited resources to pay for treatment and hoped that the federal Cleft Lip and Palate Scheme would cover the costs, which turned out that only extractions and dentures are eligible for the claim. Thus, the treating clinician – Dr Michael Mandikos and I had decided to treat...

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