Systematic Approach to Restoring No. 8: Diagnostics, Tissue Control and Esthetics

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In this case discussion, I walk through the esthetic and technical decisions behind restoring a single central implant next to natural teeth. While cases like this may appear simple at first glance, even subtle discrepancies in shade, tissue thickness, emergence profile, or axial inclination can make a result look unnatural. My goal is to show how I diagnose these nuances and sequence treatment so the final restoration feels harmonious and seamless.

You’ll see how calibrated photography guides every step of my workflow, how I use the provisional restoration to sculpt healthier, thicker tissue, and why separating the abutment and crown gives me greater control over shade and esthetic outcomes. I also highlight the small refinements in line angles, proportions, and axial inclinations that elevate the final result—even when restoring only a few teeth.

Throughout the session, I share strategies that improve communication with the lab, reduce the risk of remakes, and deliver predictable, natural-looking esthetics in one of the most unforgiving areas of the smile.

Key Takeaways:

• Start with Facial Orientation: Align photos to the patient’s face before diagnosing.
  

• Benchmarks Guide Everything: Establish vertical and horizontal references for pink and white esthetics.
  

• Tissue Thickness Matters: Adjusting the provisional’s emergence profile can improve tissue color and contour without invasive procedures.
  

• Separate the Abutment and Crown: Gain control, improve shade matching, and prevent unnecessary remakes.
  

• Strengthen Lab Communication: Try-in photos of the abutment alone and the crown on top allow precise refinements.
  

• Use the Provisional to Shape Tissue: Outlining cervical margins and modifying internal contours supports healthier, thicker tissue.
  

• Micro-adjustments Create Macro Changes: Small tweaks in angles, proportions, and axial inclinations dramatically enhance esthetics.

This case discussion is included in the Case Continuum.

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