Dr. Myra Brennan 

April 19, 2023 

Treatment Challenges & Solutions in the Anterior Maxillary Esthetic Zone 

Comprehensive pre-treatment esthetic, occlusal, and periodontal assessment is critical to select and design an optimal implant prosthetic restoration. This presentation will cover interdisciplinary considerations for restoring both single and partially edentulous sites with dental implants in the anterior maxillary esthetic zone. Principles of digital smile design as it relates to facial integration of tooth proportions, gingival contours and edentulous ridge form will be discussed, along with interdisciplinary treatment strategies to manage implant site deficiencies in interdental width, bone and soft tissues. 

Cases presented will highlight both Digital and Analog treatment approaches for fixed cemented and screw retained implant restorations, pre-prosthetic site management with orthodontics, bone regeneration, soft tissue augmentation and a variety of provisional restoration options throughout each phase of treatment. 

Goal: Anticipate the challenges of implant treatment in order to manage your patients expectations with and to avoid unintended consequences such as prosthetic complications, delayed treatment, and unsatisfied patient. 

Learning Objectives: 

1. Understand the benefits of Digital Smile Design treatment planning and the Smile Simulation process to set realistic expectations for the patient prior to beginning treatment. 
2. Identify and sequence procedures and fees associated with each phase of treatment to manage cost and timing of appointments with lab and surgeon. 
3. Select provisional restorations for each stage of implant therapy: pre-extraction, post-augmentation, postimplant placement and pre-final restoration. 
4. Identify photos required by technician and ceramist to communicate ideal ceramic restoration design. 

Bio: 

Dr. Myra Brennan is a specialist in Prosthodontics and maintains a private practice limited to the Aesthetic Oral Rehabilitation of the Smile with fixed ceramic restorations and dental implants. The clinic is a Certified Digital Smile Design Clinic and is located on Hewitt’s Cove in the Hingham Shipyard. 

Dr. Brennan received her undergraduate degree from the College of Engineering at Boston University and graduated from the Goldman School of Dental Medicine at BU where she received her dental degree, and advanced certification from both the Advanced Education in General Dentistry residency program and the specialty residency program in Prosthodontics. 

She has taught at Boston University and at the University of Washington in Seattle and has been published in the prestigious journals of the International Journal of Periodontics & Restorative Dentistry and the Quintessence of Dental Technology and continues to teach and lecture on aesthetics, occlusion and comprehensive oral rehabilitation.