Aim: to present implant restorative treatment and retreatment in light of patient feedback.
Summary: A patient with extensive restorative treatment including implant supported fixed prosthodontics is presented as not satisfied with the definitive restorations, which were ultimately rejected and removed. Communication with patient was affected by the fact that he could not use his native language during discussion with the dentists involved in the treatment. Moreover, the majority of dentists who participated in the treatment could not use their native languages.
After a number of unsuccessful provisional restorations, decision is made to start over the prosthetic design approach from wax-up stage. Lately, precedence has been given to improved esthetics and lip support, while compromising on other desirable features, such as a smooth, easy to clean emergence profile. The patient was happy with the final outcome and agreed to spend extra time with hygiene measures, while benefiting from better esthetics and lip support.
Key learning points:
1. Patient expectations are paramount for treatment success and should be identified early on during evaluation phases.
2. Implant restorations are not without limitations and compromises may be necessary in order to provide an acceptable prosthesis.
3. Definitive restorations should only be fabricated and delivered after assurance that the design provided by provisionals was tried and accepted by the patient.
Keywords: implant, emergence profile, lip support
Authors: Sorin Uram-Tuculescu