This patient presents in her mid 40’s, and complains of “rotten teeth” and “tooth pains”.
Esthetic analysis reveals no upper front tooth display with a resting lip (non-ideal), and is unwilling to provide a smiling photo.
Retracted view of teeth reveals rampant dental decay of all teeth, broken teeth, collapsed bite, and draining root canal abscesses (upper gums).
Views of the upper and lower jaws reveals rampant dental decay of all teeth draining root canal abscesses (upper gums). Since all of these teeth were either unrestorable or not strategic to any comprehensive restorative plan, they would require extraction. Immediate healing dentures would replace the teeth the day of extractions, for healing and esthetic benefit for the patient. For the definitive restorative plan, the patient elected Mohave 4 implants placed on the lower jaw to support a fixed-detachable or hybrid denture prosthesis, and a conventional complete denture on the upper jaw. Other reasonable treatment options for this patient were the following: 1.) Placement of 8 implants on the upper jaw and 6 on the lower to support fixed implant bridges (the closest treatment option to real teeth). 2.) Removable implant prostheses that connect to implants for either or both jaws, requiring 2-4 implants on the lower jaw and 4-6 on the upper.
The day of tooth extractions, the four dental implants were immediately placed, and healing dentures were inserted. The esthetics of “healing dentures” are only a “best guess” due to the inability to try tooth position before the prostheses are made, unlike the definitive prostheses for which tooth position can be tried and idealized before fabrication.
View of the implants in place on the lower jaw.
After initial implant healing to the bone, the lower healing denture was converted to a transitional fixed-detachable prosthesis and rigidly connected to the implants - this is only removable by the dentist, not by the patient. Often, this can be done the same day that the implants are placed, avoiding the need for the patient to wear a lower healing denture during the healing period. As this patient needed to delay fabrication of the definitive prostheses, she elected to convert the lower healing denture to the above prosthesis to provide her with much better function during this period.
Frontal view of the definitive prostheses in place. Notice that the front teeth are longer and more natural looking than in the previous photo.
Before and after frontal views.
Pre and post treatment radiographs. The post treatment radiograph demonstrates the implant and prosthetic hardware. The 2 angled implants were placed as such intentionally to avoid damaging the nearby nerves.
Resting lip photo with the final prostheses in place. The patient now shows a slight amount of tooth with her lip at rest, which is more youthful.
Full smile photo with the final prostheses in place. The patient now has a well balanced smile.
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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!