Nobel implants and e.max crowns — two-stage implant placement using a mock-up

A woman came to us requesting aesthetic restoration of her smile. She was concerned about a dark line on the gums — the result of an old metal-ceramic bridge on three front teeth. She was also missing two teeth on the left and right sides of the upper jaw. She wanted to look natural and have a healthy, bright smile without discomfort.

After the examination, the doctor referred the patient for a 3D CT scan of both jaws to fully assess the condition of the teeth and propose a well-grounded treatment plan. The CT scan showed that the patient had retained temporary (primary) teeth: an upper right primary canine and an upper left primary second premolar. The teeth were stable and well positioned in the bone.

Based on the patient’s wishes and the diagnostic data obtained, the doctor proposed the following treatment plan:

Perform repeat endodontic treatment of the teeth (retreat the root canals) and perform endodontic treatment of the primary teeth.
Perform implant placement in the area of the missing teeth using a two-stage technique.
Perform prosthetics using a mock-up model.
Whiten the teeth of the lower jaw.
Fabricate the crowns and bridge from e.max ceramic, shade B1.

The patient agreed, and our team began treatment, which consisted of the following stages:

        STAGE 1
        
Consultation. Treatment planThe doctor examined the patient, discussed possible ways to solve the clinical problem with her, and prepared a treatment plan.

        STAGE 2
        
Professional oral hygieneBefore the surgical intervention, the patient had professional oral hygiene to sanitize the oral cavity and reduce inflammation. The upper and lower jaws were scanned to create a dental mock-up.

        STAGE 3
        
Fabrication and trial fitting of the mock-up modelAfter a couple of days, a mock-up model was made and transferred onto the teeth of the upper jaw; we evaluated the shape of the future teeth and how much material would need to be removed from her own teeth to minimize trauma.

        STAGE 4
        
Root canal treatmentOn the same day, repeat root canal treatment was performed on the permanent and primary teeth so that crowns and a bridge could later be placed on them.

        STAGE 5
        
Surgical stage (placement of Nobel implants)Two Nobel Biocare implants were placed in the area of the missing teeth. Gingiva formers were also installed. During the same visit, we whitened the lower jaw and selected a shade to match the future teeth of the upper jaw.

        STAGE 6
        
Temporary prostheticsSeven days later, we prepared the teeth of the upper jaw. The sutures in the implant placement area were removed, and temporary crowns were made for the prepared teeth.

        STAGE 7
        
Permanent prostheticsAfter 5 days, the temporary crowns were removed and the permanent crowns and bridge were fixed (except for the implant-supported teeth). A month and a half later, the patient came to the clinic; we unscrewed the gingiva formers from the implants, scanned the implants, and three days later placed the final 2 crowns.

The patient went home happy — with the smile she wanted. A natural, fresh smile without a dark margin. Missing teeth restored. Light, aesthetic crowns. Primary teeth preserved and restored with prosthetics. The treatment was completed in just 2 months.

A smile is not just about teeth. It is self-confidence, the desire to look at yourself in the mirror, laugh without embarrassment, and speak openly. We do not just “treat teeth.” We restore comfort, natural appearance, and a true sense of self.

And even if your case seems complicated — with a dark margin, bridges from the past, and childhood “baby” teeth in adult life — know this: we will find a solution. Carefully. Professionally. Beautifully.

A new smile is just one decision away. And we will take care of everything else.

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Maksym Makarenko

Oral surgeon. Clinical experience: 23 years. Doctor of Sciences.

Nobel implants and e.max crowns — an outstanding result

Maksym Makarenko

Consultation. Treatment plan

Professional oral hygiene

Fabrication and trial fitting of the mock-up model

Root canal treatment

Surgical stage (placement of Nobel implants)

Dental treatment

Dental implant placement

Temporary prosthetics

Permanent prosthetics

Summary

Maksym Makarenko

Implant placement and prosthetics with “zirconia” crowns

Straumann implant placement and zirconia crowns

Our services

Patient documents