This was approached as one of our complex cases when the patient decided to do away with her partial because she wanted fixed teeth. As she had deep gingival defects this case was going to require pink porcelain. The material was chosen because of the strength that was required and the color of the tissue and the amount of tissue.  Custom implant abutments were also utilized because of her varying bone depth and the challenges of getting the implant abutments parallel.
Riverside Dental Studio was chosen to do the case because of our reputation. The dentist had never used Riverside before but had heard that in this situation Riverside was his best choice.

Matching her existing PFM on the central was also a big challenge and something that had to be exact to meet the results the patient demanded.

After the custom abutments were made parallel and polished it was time to design the case. Riverside Dental Studio always designs a complex case in wax first. Whether it is a diagnostic wax up or the final wax up that will be scanned, a complex case demands an exact plan. A diagnostic wax up always provides this. If there is any question on length of incisors, incisal edge placement, overjet or bite, the wax up is the answer.After the wax up is scanned it is milled out of plastic. This temporary plastic is tried in to make sure that it fits the implants exactly and can be worn for a few days by the patient to make sure all of the landmarks are in the correct position. As it is just temporary plastic, changes can be made easily. After it is determined that this was milled correctly and everything is in the right place, then the final monolithic restoration can be milled.

A shaded puck is used for depth of color even though it will probably still be altered as the case continues. After the milled zirconia is quality controlled, it is touched up with some light staining and then sintered.

The case is layered according to the custom shade on the central. The pink porcelain is layered and stained to accomplish a good gingival color.