01 Pour the impressions and fabricate and mount the master models (Fig. A). Because of the depth of the fixture heads, ovate contours were developed for tissue support and emergence profiles (Figs. B and C).

02 Verify the implants (Nobel Biocare Replace Select) on the model (Fig. D). Fit, wax, and cast the appropriate abutments. For this case, UCLA-style abutments (Nobel Biocare Goldadapt) were cast from a ceramic alloy.

03 After metal finishing, opaque the abutments (Fig. E). In this case, the abutments were opaqued and subgingival contours and margins formed using IPS d.SIGN fluorapatite glass ceramic from Ivoclar Vivadent (Fig. F).

04 Wax the definitive crowns to full contour (Fig. G) and create an incisal matrix using Sil-Tech putty (Ivoclar Vivadent).

05 Cut back the wax patterns incisally and facially to allow sufficient room for layering of the veneering porcelain (Fig. H).

06 Sprue and invest the wax patterns for pressing (Fig. I). These crowns were pressed with medium opacity (MO) glass ceramic ingots (IPS e.max Press) to complement the opaqued metal abutment. Verify fit of the crowns on the abutments and master cast (Fig. J).

07 Internally stain the frameworks to create the desired esthetic and characterized effect (Fig. K). Dust the crowns with IPS e.max Ceram effect powder for a “wash” firing (Fig. L).

08 After firing, layer a combination of enamels and effect powders (Figs. M and N) using the Sil-Tech matrix to maintain the proper incisal edge position. Fire the crowns.

09 Fit restorations to master model using various diamond burs and wheels. Final contours are established at this point. After contours and function are verified, glaze the restorations.

10 Fit finished restorations to the custom abutments (Figs. O and P). Place restorations and custom abutments on the master model (Fig. Q).

11 Fig. R shows the try-in of the custom abutments. Fig. S shows the final restorations seated in the mouth after cementation. Fig. T is a retracted view.

Fig. A View of the master model fabricated in the laboratory.	Fig. B Ovate contours were created in this case for tissue support and emergence profiles because of the depth of the fixture heads.	Fig. C View of the completed sites on the master model.
Fig. D Castable implants (Nobel Biocare Replace Select) were fitted to the master model.	Fig. E Cast UCLA-style abutments were opaqued.	Fig. F The subgingival contours and margins were created using a fluorapatite glass ceramic (IPS d.SIGN) and fired.
Fig. G The definitive crowns were waxed to full contour.	Fig. H An incisal matrix was made (Sil-Tech), after which the waxup was cut back.	Fig. I The wax patterns were sprued for investing.
Fig. J View of the pressed frameworks after pressing.	Fig. K The frameworks were internally stained for effect.	Fig. L The frameworks were dusted with e.max Ceram effect powder as a wash firing.
Fig. M The incisal matrix served as a guide when layering the enamels and effects.	Fig. N The matrix was removed, and additional porcelain was added to compensate for shrinkage.	Fig. O View of the completed restorations and abutments.
Fig. P View of the completed restorations and abutments.	Fig. Q View of the restorations backlit to demonstrate light transmission.	Fig. R The try-in of the abutments demonstrates the gingival warmth of these restorations.
Fig. S Final postoperative view of the definitive restorations. Note the harmonious and pleasing smile created despite less-than-ideal preoperative circumstances.	Fig. T Retracted view of the definitive restorations.