CLINICAL CASE

Restorationof a missing
lateral incisor

Tidu Mankoo
United Kingdom

Case courtesy of Tidu Mankoo

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Tidu Mankoo

Dental technicians Luc & Patrick Rutten

Case description
Restoration of a missing lateral incisor

Patient with congenitally missing right and peg-shaped
left lateral incisor.

Patient
22 years, male

Orthodontic treatment was carried out to align theteeth and create the correct space for restoration ofboth lateral incisors.

Clinical situation
Congenitally missing right lateral andpeg shaped left lateral maxillary incisor
Surgical solution
Extraction & immediate placement ofNobelActive® TiUltra™ implant
Restorative solution
Temporary: SnapTemp abutment
and Tempshell crown
Final: NobelProcera® ASC Full Contour
Zirconia Implant Crown

The maxillary left incisor was restored with a lithium
disilicate veneer followed by extraction of rightdeciduous lateral incisor with immediate placementof a NobelActive® TiUltra™ implant and immediateprovisionalisation.
Simultaneous soft tissue augmentation was carried out
with sub-epithelial connective tissue graft.

Surgery date(s)April, 2019
Total treatment time
3 months
Tooth position(s)12Case courtesy of Tidu Mankoo

2/12Initial clinicalsituation

Treatmentplanning

Surgicalprocedure

Case courtesy of Dr. Tidu Mankoo

Restorative
procedure

OutcomeCase courtesy of Dr. Tidu Mankoo

Case courtesy of Dr. Tidu Mankoo

Case courtesy of Dr. Tidu Mankoo

Case courtesy of Dr. Tidu Mankoo

Clinical view of patient with retained deciduous right maxillary lateralincisor and peg-shaped left lateral. Note the poor relative proportionsof the incisors, anterior crowding and the lack of adequate space forthe maxillary lateral incisors.

Case courtesy of Dr. Tidu Mankoo

Case courtesy of Dr. Tidu Mankoo

Case courtesy of Dr. Tidu Mankoo

Apical root resorption of the retained right lateral incisor.

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3/12Initial clinicalsituation

Treatmentplanning

Surgicalprocedure

Case courtesy of Dr. Tidu Mankoo

Restorative
procedure

OutcomeCase courtesy of Dr. Tidu Mankoo

Case courtesy of Dr. Tidu Mankoo

Case courtesy of Dr. Tidu Mankoo

Case courtesy of Dr. Tidu Mankoo

Case courtesy of Dr. Tidu Mankoo

Case courtesy of Dr. Tidu Mankoo

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Clinical situation after 14 months of orthodontic treatment.

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Initial clinicalsituation

Treatmentplanning

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Case courtesy of Dr. Tidu Mankoo

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Case courtesy of Dr. Tidu Mankoo

Surgicalprocedure

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Case courtesy of Dr. Tidu Mankoo

Case courtesy of Dr. Tidu Mankoo

Case courtesy of Dr. Tidu Mankoo

Restorativeprocedure

OutcomeCase courtesy of Dr. Tidu Mankoo

Case courtesy of Dr. Tidu Mankoo

Case courtesy of Dr. Tidu Mankoo

Case courtesy of Dr. Tidu Mankoo

Digital planning of the implant placement and digitally designed TempShell in the DTX Studio™ Implant software.

Case courtesy of Tidu Mankoo

5/12Initial clinicalsituation

Treatmentplanning

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Case courtesy of Dr. Tidu Mankoo

Case courtesy of Dr. Tidu Mankoo

Case courtesy of Dr. Tidu Mankoo

Immediate postoperative situation with temporary crown in place
on a 3mm SnapTemp abutment and a connective tissue graft toaugment labial volume.

Surgicalprocedure

Restorative
procedure

OutcomeCase courtesy of Dr. Tidu Mankoo

Case courtesy of Dr. Tidu Mankoo

Case courtesy of Dr. Tidu Mankoo

Case courtesy of Dr. Tidu Mankoo

Case courtesy of Dr. Tidu Mankoo

Case courtesy of Dr. Tidu Mankoo

Case courtesy of Dr. Tidu Mankoo

Case courtesy of Dr. Tidu Mankoo

NobelActive® TiUltra™ 3.5 x 10 mm
implant.

Radiograph of the NobelActive®
TiUltra™ implant with theSnapTemp abutment right after
the surgery.
Case courtesy of Tidu Mankoo

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Initial clinicalsituation

Treatmentplanning

Case courtesy of Dr. Tidu Mankoo

Case courtesy of Dr. Tidu Mankoo

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SurgicalprocedureCase courtesy of Dr. Tidu Mankoo

Case courtesy of Dr. Tidu Mankoo

Case courtesy of Dr. Tidu Mankoo

Case courtesy of Dr. Tidu Mankoo

Case courtesy of Dr. Tidu Mankoo

Case courtesy of Dr. Tidu Mankoo

Restorative
procedure

OutcomeCase courtesy of Dr. Tidu Mankoo

Case courtesy of Dr. Tidu Mankoo

Case courtesy of Dr. Tidu Mankoo

Case courtesy of Dr. Tidu Mankoo

Case courtesy of Dr. Tidu Mankoo

Case courtesy of Dr. Tidu Mankoo

At 2 months, impressions were taken (both conventional and digital) and shade communication provided to the laboratory.
The temporary was refitted.
Case courtesy of Tidu Mankoo

7/12

Initial clinicalsituation

Treatmentplanning

SurgicalprocedureCase courtesy of Dr. Tidu Mankoo

Restorative
procedure

OutcomeCase courtesy of Dr. Tidu Mankoo

Case courtesy of Dr. Tidu Mankoo

Case courtesy of Dr. Tidu Mankoo

Case courtesy of Dr. Tidu Mankoo

Case courtesy of Dr. Tidu Mankoo

Case courtesy of Dr. Tidu Mankoo

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Case courtesy of Dr. Tidu Mankoo

Case courtesy of Dr. Tidu Mankoo

Case courtesy of Dr. Tidu Mankoo

Case courtesy of Dr. Tidu Mankoo

Case courtesy of Dr. Tidu Mankoo

Case courtesy of Dr. Tidu Mankoo

Case courtesy of Dr. Tidu Mankoo

Case courtesy of Dr. Tidu Mankoo

Case courtesy of Dr. Tidu Mankoo

DTX Studio™ Lab software was utilized to design the zirconia framework for a NobelProcera® ASC Full Contour Zirconia Implant Crown withlabial cutback and veneered with porcelain on the labial side (work by Luc & Patrick Rutten).
Case courtesy of Tidu Mankoo

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Initial clinicalsituation

Treatmentplanning

Case courtesy of Dr. Tidu Mankoo

Surgicalprocedure

Case courtesy of Dr. Tidu Mankoo

Case courtesy of Dr. Tidu Mankoo

Restorative
procedureCase courtesy of Dr. Tidu Mankoo

Case courtesy of Dr. Tidu Mankoo

Case courtesy of Dr. Tidu Mankoo

OutcomeCase courtesy of Dr. Tidu Mankoo

Case courtesy of Dr. Tidu Mankoo

Case courtesy of Dr. Tidu Mankoo

Delivery of the final prosthetic 3 months after the implant placement.

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Initial clinicalsituation

Treatmentplanning

SurgicalprocedureCase courtesy of Dr. Tidu Mankoo

Restorative
procedure

OutcomeCase courtesy of Dr. Tidu Mankoo

Case courtesy of Dr. Tidu Mankoo

Case courtesy of Dr. Tidu Mankoo

Case courtesy of Dr. Tidu Mankoo

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1 week follow-up: Intraoral view of the final restoration.

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10/12Initial clinicalsituation

Treatmentplanning

Case courtesy of Dr. Tidu Mankoo

Case courtesy of Dr. Tidu Mankoo

Surgicalprocedure

Restorative
procedureCase courtesy of Dr. Tidu Mankoo

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OutcomeCase courtesy of Dr. Tidu Mankoo

Case courtesy of Dr. Tidu Mankoo

Case courtesy of Dr. Tidu Mankoo

Clinical situation showing pleasing esthetic result after one month of follow-up.

Radiograph of the implant andthe final prosthesis.
Case courtesy of Tidu Mankoo

11/12Case courtesy of Dr. Tidu Mankoo

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