Owen is a 23 year old male who went through ortho as a child with the idea we would do implants when he stopped growing. At age 13, Maryland bridges were fabricated to maintain the spaces created for the implants. Unfortunately, when the surgeon did a CBCT scan at age 19 there was inadequate room for implants due to the roots of the central and cuspids converging on the implant sites. A second round of ortho was necessary.
The initial picture (Fig. A) is where Owen was as the start of his second round of ortho and the second picture (Fig. B) is after implants were placed. The third picture (Fig. C) shows the custom provisionals over the implants as well as the minimal veneer preparations on the centrals and cuspids. Figures D and F are of the final restorations, virtually no prep veneers on the centrals and cuspids, as well as custom abutments and crowns on the laterals.