Problem
This 48-year-old woman came to us desperately in need of a solution because she had been diagnosed with severe periodontal disease, and all her teeth had to be extracted. Besides, she was not happy with the way her teeth looked.

Approach
After a complete clinical exam, a full set of photos, and a CT scan, we could confirm that all her teeth were hopeless because of gum disease and their severe bone loss.
Based on the dental impressions, we created a customized digital smile design for her. Our goal was to restore her functionality and improve her appearance. Because of periodontal disease and especially severe bone loss, this treatment was planned in three stages (visits).

Visit 1
In the first stage, extractions, bone grafts, bilateral sinus augmentations, and eight dental implants were performed. The patient had to leave with regular dentures as temporary teeth, which were also based on the digital smile design. This was necessary while the implants healed into the bone.

Visit 2
In the second stage, six months later, she returned to Costa Rica to receive the four remaining implants and to get some temporary plastic bridges that would go over the first set of implants—this was a new set of fixed temporaries. This was done to improve her quality of life while the second set of implants healed into the bone, and she could have had the final set of teeth.
Visit 3
Third Stage and final visit. This time, she came to Cancun and was ready to receive her final set of zirconium structures. Based on the smile design, the second set of plastic teeth was tested to ensure everything fitted as planned.
End
The zirconium structures were delivered and secured with screws; she was given two days to try them out and make sure she was comfortable with her new set of teeth.
She has lost the fear of losing her teeth, and now she is back in the real world with a smile that is functional and has the look she always dreamed of.