The implant crowns were carefully removed. Healing progressed rapidly: just two days after removal, significant tissue recovery was already visible. However, the titanium of the implant fixtures remained visible through the gingival tissue, a challenge to be addressed with grafting.

Before any restorative work could begin, the teeth needed to be moved into more favorable positions. A one-year Invisalign treatment was prescribed to expand the constricted arches and create the space needed for the final restorations.

After the implant crowns were removed and while the Invisalign aligners were being fabricated, Rebecca wore a temporary Snap-on-Smile appliance so she could go about her daily life with confidence.

Incremental tray changes gradually expanded the dental arches. By the four-month mark, meaningful progress was already visible, and by the end of the full treatment, both the upper and lower arch forms were completely expanded.

With the arches now in their ideal positions, the next step was to address the visible titanium implant metal beneath the gumline, which required a connective tissue graft to thicken and mask the tissue overlaying the implants.

Donor connective tissue was harvested from Rebecca’s palate and threaded into a tunnel created beneath the existing gingival tissue in the implant area. The graft was secured on each end with sutures, providing additional tissue bulk to mask the underlying titanium.

With the arches expanded, tissue grafted, and healing complete, the final restorations were designed: two conventional porcelain bridges spanning the implant sites, plus two premolar porcelain veneers bilaterally to fill the full smile frame.

Before cementing permanently, Rebecca wore acrylic temporaries for a “test drive” of her new smile, allowing her to experience the result and confirm her satisfaction before final placement.