11-1 12 — Smile view. When the porcelain fabrication is done exceptionally well, the bridge looks like beautiful natural teeth. Result- very happy patient.

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This unfortunate patient had implants placed many years ago in another state, by a periodontist. The left implant failed along with all the bone around it. The right implant was placed in such a poor position it could not be used.

The right implant (tooth #6) was so poorly placed that if could not be used. It is too close to the tooth behind and is too far out of the arch form. It was left in the bone because it would have required too much bone loss to remove it.

X-ray of #6. Note the proximity to the tooth behind and how far it is from the tooth in front. Ideally, a well-placed implant is positioned at the midpoint between the two natural teeth. Also, noteworthy is the shortened roots from previous orthodontics (braces).

Left side missing tooth (#11). A dental implant had been attempted here. After its failure almost all the bone was lost. Without at least one area of bone a bone graft cannot work.

X-ray of missing bone at #11. The bone is missing on the lip-side and on the palate side. Without at least one of these walls present a bone graft will not work.

The decision to complete a fixed bridge using teeth was made. The other natural teeth, #s 5, 7, 8, 9, 10 and 12 are prepared for a bridge and the impression sent to the lab. Here, a stunning 8-unit bridge is seen on the master cast.

The same bridge seen in the mouth from the front. Note the beautiful color, contours and character. Even though teeth are missing, it would be very difficult to tell where. Can you guess?

Backside view of the bridge on the master cast. In long span bridges, like this, a metal skeleton is used to increase strength. This metal is not visible from the front and can only be seen by the dentist.

Backside view in the mouth.

Frontal view with black background. Again, note the very lifelike color, contours and character. Her soft tissue health is very good thanks to proper contours and her homecare regimen.