Phil discovered our practice through his church community.

He had witnessed transformations in others and was encouraged by the Inspire Changes Foundation, as well as Dr. Hutton and Dr. Gable’s collaborative, digital approach to achieving aesthetic outcomes.

Initial Condition & Life Before Treatment

Phil had battled advanced periodontal disease and failing teeth for years.

His smile was unsightly, his teeth were loose, and chewing most foods was nearly impossible.

Chronic infections and pain were a constant burden.

As a national public advocate and speaker, Phil felt ashamed of his smile and knew he was living on borrowed time with his failing teeth.

Several dentists told him he would need years of multiple surgeries if he wanted a chance to restore his smile, a path he felt was overwhelming and unrealistic.

A full smile transformation: loose, painful teeth were removed and replaced with a stable, implant-supported restoration.

First Appointment & Discovery

During his consultation, Dr. Hutton clearly explained the causes and progression of periodontal disease, outlining all available treatment options.

He presented the risks and benefits of trying to save teeth one by one versus choosing a more definitive solution: the All-on-X approach with pterygoid implants.

Phil left his appointment feeling reassured by the clarity of the explanation and confident that a path to restoring his smile and lifestyle was within reach.

Misunderstandings or Clinical Oversights

A frequent oversight in cases like Phil’s is assuming implants can be placed safely while periodontal infection remains active.

Untreated periodontal disease is the number one risk factor for peri-implantitis, with patients facing up to a 40% higher risk of implant complications.

By addressing the disease first and carefully planning treatment, these risks were avoided.

Treatment Plan & Approach

The plan included:

• Digital Planning: Intraoral scanning, CBCT imaging, and comprehensive digital workflow.

Digital planning technology mapped out the precise placement of Phil’s seven implants, including two pterygoid implants for added stability.

• Team Collaboration: Partnership with Cyber Ceramics Laboratory (Orange County), nationally recognized for All-on-X prosthetics.
• Surgical Execution: Placement of seven implants, including two pterygoid implants in the posterior maxilla (base of the skull). This enabled full restoration of all 14 upper teeth, including molars.

This approach minimized cantilevers (overhangs), improved durability, and delivered the long-term stability and function Phil needed.

Case Progression & Key Milestones

Surgery Day: Diseased teeth were removed, bone was prepared, and seven implants were placed. Phil left the office the same day with a full provisional restoration and a confident new smile.

Before surgery: advanced periodontal disease and bone loss made saving the teeth impossible. Full-arch implant treatment was the best long-term solution.

Post-surgery X-ray shows all seven implants in place. The pterygoid implants provide secure anchorage in the upper jaw, allowing Phil to regain molars and full chewing strength.

The GuidedSMILE system ensured accuracy and efficiency during surgery. Custom guides and provisional teeth allowed Phil to leave with a new smile the very same day.

Recovery: Healing was smooth with minimal discomfort. He followed a modified diet for several weeks before resuming his everyday chewing habits.

Impressively, he returned to work the following week.

Final Prosthesis: After tissue healing, Cyber Ceramics fabricated natural-looking zirconia-porcelain teeth. They seated seamlessly and fit perfectly from the first day.

Phil’s new smile foundation: a custom-designed full arch prosthesis  and underside with titanium framework, engineered for comfort, strength, and lasting peace of mind.

Surgical view: seven implants, including two pterygoid implants, were placed for maximum stability and function. Precise implant placement improved chewing strength and long-term durability.

Outcome

All seven implants, including the two pterygoids, achieved excellent stability. The full-arch restoration restored complete function with uneventful healing.

The zirconia-porcelain teeth displayed lifelike translucency and esthetics indistinguishable from natural dentition.

Phil regained complete confidence. He now speaks freely, smiles without hesitation, eats without restriction, and even returned to jiu-jitsu (with a protective mouth guard).

“I love my implants.” — Phil

Restore comfort, function, and confidence. Discover what’s possible with skilled, compassionate care.

Showing perfect diction just a minute after the new teeth were placed—no adjustments needed, a true testament to the precision of restorative and cyberceramics.

Clinical Notes for Referring Doctors

This case highlights the successful use of All-on-X with pterygoid implants for advanced periodontal disease and non-restorable dentition.

Immediate implant placement and provisionalization provided full function the same day.

The use of pterygoid implants allowed inclusion of molars in the final prosthesis, minimizing cantilevers and improving biomechanics.

Healing was uneventful, and final zirconia prosthetics provided excellent esthetic and functional results.

Marianne was referred by a long-time patient and friend who had been receiving care at the practice for several years.

With trust already established through that connection, Marianne arrived with hope—and a broken front tooth.

Initial Condition & Life Before Treatment

Tooth #8 had a long history.

Years earlier, trauma led to a root canal. Over time, the tooth had discolored, though it remained functional.

Seeking to improve her smile, Marianne had internal whitening performed by an endodontist. However, just three months after that procedure, the tooth’s crown fractured spontaneously.

This sudden break left Marianne in both a physically and emotionally difficult position.

Her central front tooth—a focal point of her smile—was deemed non-restorable, and the idea of a visible prosthetic or complex replacement filled her with concern.

First Appointment & Discovery

At her first appointment, a thorough clinical exam and X-rays revealed there wasn’t enough remaining structure to support a lasting restoration.

The verdict was clear: the tooth could not be saved.

A follow-up with her restorative dentist confirmed that the best course of action was to extract the tooth and move toward implant replacement.

Showing a large filling and minimal natural structure, making the tooth non-restorable.

Why This Case Required Advanced Expertise

This wasn’t just about replacing a tooth—it was about restoring harmony, function, and esthetics in one of the most visible areas of the smile.

The patient also had specific requests: she did not want donor-derived (allograft) or animal-based (xenograft) materials used.

Instead, the team would need to rely entirely on her own tissue to rebuild the site and support an implant. This, combined with the need for esthetic excellence, required careful digital planning, precision surgery, and interdisciplinary collaboration.

Treatment Plan & Approach

To begin, a 3D X-ray was taken to digitally map the site and guide the surgical plan. The fractured tooth was gently extracted, and an implant was placed immediately.

A free gingival graft was also performed at the time of extraction.

In place of donor or animal grafts, the patient’s own bone—harvested from a nearby tori—was used to support the implant.

A small blood sample was drawn and processed into a healing membrane called Leukocyte- and Platelet-Rich Fibrin (L-PRF), which was applied to enhance recovery.

To ensure esthetics during healing, an Essix retainer with a temporary tooth was provided, allowing Marianne to maintain a natural-looking smile throughout her Invisalign treatment.

The ovate pontic on the Essix retainer helped shape the gum tissue, creating a natural-looking emergence profile.

The implant was uncovered, a healing abutment was placed, and a ridge augmentation was performed to improve the gingiva contour.

Case Progression & Key Milestones

Later in the healing process, a ridge augmentation was performed at the time of implant uncovering to refine the soft tissue contours and improve the emergence profile.

The coordination between surgical and restorative teams ensured that each phase built seamlessly on the last, culminating in a result that was both functional and beautiful.

Outcome

Thanks to Dr. Hutton’s expertise, the implant achieved excellent stability and integration, with no complications.

Healing was smooth, and the use of autogenous tissue supported robust soft tissue health.

Because of the careful implant placement and ridge augmentation, the final crown mimicked the natural tooth in both shape and gum contour. The gumline emerged naturally around the new tooth, blending flawlessly with adjacent teeth.

Marianne expressed deep satisfaction with the outcome.

The use of her own tissue and a treatment process grounded in trust, collaboration, and precision helped restore not just her tooth but also her confidence and peace of mind.

Trust your smile to specialists who put patients first, with minimally invasive solutions designed to last.

Tooth #8 shows a visible fracture, indicating structural compromise and the need for further evaluation and treatment

Showing the completed restoration with a natural and seamless appearance

Clinical Notes for Referring Doctors

This case demonstrates the successful management of a fractured, non-restorable maxillary central incisor using immediate implant placement, autogenous bone harvesting, and soft tissue augmentation with L-PRF membranes.

No allografts or xenografts were used, as per the patient’s request. A second-stage ridge augmentation enhanced soft tissue contour and esthetics.

Coordination between the surgical and restorative teams ensured ideal outcomes. Dr. Hutton welcomes referrals for esthetic zone cases requiring biologically conservative and technically demanding implant reconstruction.