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ANTERIOR IMPLANT RESTORATIONS – CHALLENGE AND COMPROMISE. A CASE REPORT ANTERIOR IMPLANT RESTORATIONS – CHALLENGE AND COMPROMISE. A CASE REPORT Abstract 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. Cite this article: Uram-Ţuculescu S. Anterior Implant Restorations – Challenge and Compromise. A Case Report. Stoma Edu J. 2014; 1(2):131-137. Sorin Uram-Ţuculescu* Department of Prosthodontics, School of Dentistry, Virginia Commonwealth University Richmond, VA, USA DDS, MS, PhD, Assistant Professor Keywords: implant, emergence profile, lip support Introduction After decades of implant dentistry with predictable results, titanium implants of various shapes and textures claim a mainstream role in providing infrastructure in state-of-the-art restorations. Despite impressive standardization and ease of use of treatment protocols, anterior restorations supported by implants may still encounter problems. Sometimes, clinically satisfactory prostheses, as assessed by practitioners, are not accepted by certain patients. Case Presentation and History During the following, the reader is presented with a clinical case resto red in the Department of Graduate Prosthodontics in the School of Dentistry – University of North Carolina (UNC) at Chapel Hill, U.S.A. Mr. CM (male, 50 years old) presented with moderate generalized and localized severe periodontitis (Fig.1 a, b), seeking for treatment options. After a comprehensive STOMA.EDUJ (2014) 1 (2) Received: 28 August 2014 Accepted: 13 September 2014 *Corresponding author: Assistant Professor Sorin Uram-Tuculescu, DDS, MS, PhD Department of Prosthodontics, School of Dentistry, Virginia Commonwealth University Wood Memorial Building, 521 North 11th Street, Room # 304 D PO Box 980566 Richmond, VA 23298-0566, USA Tel: 804-628-3742, Fax: 804-827-1017 e-mail: suramtucules@vcu.edu 131