Implant-Supported Restoration for Missing Lower Right Molars: Bone Graft, Connective Tissue Graft, and Zirconia Crowns
Meet our patient who had his lower right first and second molars (LR6 and LR7) removed years ago. He tried a denture but found it unstable for chewing, so he pursued a fixed, implant-supported solution to restore function and aesthetics. This case highlights a staged approach with bone and gingival augmentation to ensure long-term stability.
Case Overview
- Initial issues: Missing lower right molars with reduced bone width and limited attached gingiva
- Previous prosthesis: Denture with inadequate function and comfort
- Goals: Restore denture-free chewing with stable implants, adequate keratinised tissue, and natural aesthetics
- Planned interventions: Two dental implants, bone grafting (and connective tissue graft), PRF-assisted healing, custom abutments, and zirconia crowns splinted for strength
Why This Approach Works
- Fixed, durable rehabilitation: Replaces missing molars without affecting adjacent teeth
- Bone and soft-tissue optimisation: Bone grafting with PRF enhances regeneration; connective tissue graft increases keratinised tissue for implant longevity
- Enhanced healing: PRF (platelet-rich fibrin) provides growth factors that support grafts and soft-tissue integration
- Robust prosthesis: Custom abutments and a two-crowns splinted together offers improved strength and durability
Treatment Timeline
Stage 1: Implant Placement and PRF-Enhanced Bone Grafting
- Place two dental implants at the LR6 and LR7 sites
- Harvest autologous PRF from the patient’s blood and combine with bone graft material to boost volume around the implants
- Benefits: Accelerated healing and improved graft integration
Stage 2: Soft-Tissue Augmentation
- After approximately 3 months of uneventful healing, uncover the implants and fit healing caps
- Perform connective tissue grafting around the implants to increase keratinised tissue
- Technique: BioLase diode laser-assisted grafting to promote optimal soft-tissue healing
Stage 3: Final Restoration
- About 3 weeks after the soft-tissue graft, obtain digital scans for fabrication
- Create two custom abutments and zirconia crowns
- Prosthetics: Crowns splinted together to share load and enhance long-term strength
Outcome
- The final implants and crowns provide a natural appearance with ideal bite contact
- Increased gum health profile reduces food trapping and gum-related issues
- A denture-free, confident smile with durable, predictable function
Treatment Gallery
Before Treatment
After Treatment
After Treatment
Before Treatment
After Soft Tissue Graft
After Treatment
Lower Right Molar Implants
Am I a Good Candidate?
If you’re missing molars and seeking a fixed solution with or without bone and gum augmentation, our team can assess suitability for an implant-supported rehabilitation. We tailor planning to your bone, tissue, and bite needs, guiding you through every stage from planning to final restoration.
