Treatment process
This patient presents in his mid 70s with a substantial amount of previous crown and bridgework which is now failing. The Restorations demonstrate multiple porcelain fractures, underlying decay, mobility, as well as several root canal abscesses.
Esthetic evaluation demonstrates mismatched tooth color between upper and lower teeth, as well as an imbalanced smile plane, and poor tooth size proportions.
After close examination, the degradation of the upper arch was determined to be too severe to be salvaged without heroics, due to the extensiveness of dental disease and abscesses.
On the lower jaw, the right bridge (left side of screen) will be lost due to abscesses and periodontal disease, the crowns on the opposite side have structurally failed down to the metal substructure. Decay is also present on several front teeth.
After discussion with the patient about the diagnosed problems and possible treatment options, a final treatment plan was formulated. The most reasonable treatment plan for this patient given the gamut of his problems, was extraction of all upper teeth and the lower right bridge. Definitive prosthetic replacement for the upper jaw was planned for placement of 4 dental implants to support a removable implant prosthesis. For the lower jaw, new crowns were to be made on the lower left, front teeth to be conservatively restored with tooth colored composite resin veneers, and the right segment would receive 2 implants to support a bridge. Because healing is required after tooth extraction and implant placement, the patient did wear an immediate denture on the upper jaw for an interim period of four months before the final implant prosthesis could be made. The treatment plan involves fixed and removable prosthodontics, in combination with dental implants.
This photo of the upper jaw show the four implant attachments used to help support and retain the patient’s removable implant prosthesis.
This is a photo of the removable implant prosthesis in place on the upper jaw. When 4-6 implants are used, the palate portion (roof of the mouth) can be left open to allow the patient more tasting sensation when they eat.
Then on the lower jaw, 4 new crowns were provided on the patient’s left (right side of photo), the 6 front teeth were bonded to proper form with composite resin, and the patient’s right side received a 3-unit bridge held by 2 implants.
Front view of final restorations.
Final smiling photo of final restorations. Tooth display, proportions, and the bite plane are now much more balanced.
Before and after frontal view. Tooth display, proportions, and the bite plane are now much more balanced - providing the patient with better esthetics and function.
Pre and post treatment radiographs. The post treatment radiograph demonstrates the final restorations and dental implants in place.
Full face photo of the patient with the final restorations in place, and a happy patient!
Ready to Start Your journey?
At Meng Dentistry we welcome all dental patients including those needing more complex dentistry. We provide the full range of Prosthodontics, cosmetic dentistry, and general dentistry including, teeth whitening, esthetic bonding, dental veneers, crowns, bridges, removable prostheses (dentures and partials), maxillofacial prosthodontics (obturators), and dental implants. Call today to see how Meng Dentistry can transform your smile!
