Full Mouth Rehabilitation

Patients who have many missing teeth or severe deterioration of most teeth, may require a full mouth reconstruction using a combination of restorations, veneers, crowns, bridges, dental implants or partial dentures. The oral cavity is a dynamic environment where changes constantly occur, sometimes quickly but more often slowly over time. Changes can be due to a traumatic accident, periodontal disease, shifting teeth, a lifetime of neglect, a destructive habit such as grinding, or a lifetime of dentistry focusing on one tooth at a time and leaving the mouth resembling a patchwork quilt.

Case study: This patient has an ill-fitting, unstable denture combined with a deep bite and general tooth discolouration which is a major aesthetic and functional concern. We treated it by improving colour and tooth arrangement using a combination of porcelain and composite veneers and new upper and lower partial cosmetic prosthesis.

Full-mouth reconstruction, by its very nature can be extremely complex. Dental techniques and technologies have come a long way in the past 30 years and patients are often surprised by what can be done. Correct diagnosis and analysis is important to identify and address the causes of the problems in the treatment plan. Treatment is often a non-surgical, comprehensive approach to getting the upper and lower jaws in proper alignment, removing all decay, repairing all chipped, weakened, and broken teeth, and ultimately, creating a healthy, attractive smile that will last for many years.

Once this treatment is completed you can expect a mouth that looks great, feels comfortable, and gives you the confidence to smile. If you are experiencing bite-related problems, feel that your teeth or gums have been allowed to deteriorate or feel your mouth is in poor condition, a full-mouth reconstruction may be the appropriate solution.

Our patient here chose a non-surgical option for personal reasons. The patient presented with inadequately fitting upper partial denture and an incorrectly instituted treatment plan resulting over a period of time: multiple loss of teeth that resulted in loss of jaw bone and facial height resulting in an accelerated ageing appearance. We solved the problem by improving the facial height (raising the bite), improving the upper smile line using a combination of porcelain veneers, upper and lower precision milled, highly aesthetic and firm partial dentures to restore the following:

Facial and dental aesthetics
Comfort
Function

Tooth Replacement Options

This is often a difficult question, but one about which Dr Nalbandian, in practice of prosthodontics (specialised area of dentistry related to reconstruction of teeth and supporting structures)) is experienced in advising. Some of the general advantages and disadvantages of single to multiple tooth replacement options are listed below.

	Advantages	Disadvantages
Removable partial dentures	Removable – good access for cleaning Cost effective Very minor tooth reduction required	Reduced comfort Possible clasp display Gaps visible on removal Patient intolerance Food traps, if not properly maintained, can cause dental caries
Implant replacement	No tooth reduction required Access for cleaning similar to natural teeth Failure can mean just loss of the implant ,and attached crown or bridge can mean further tissue loss Minimal biological intervention compared to bridgework where adjacent teeth require preparation	Requires minimal surgical intervention, similar to normal tooth removal More expensive, however compared to bridgework it is cheaper in the long term both financially and biologically as all bridges fail at one point affecting one or more of the retaining teeth, complicating future treatments Areas of large bone loss may require bone augmentation-grafting to improve ridge anatomy/shape for better tooth emergence, function and aesthetics
Fixed bridgework	Good where adjacent teeth would benefit from crowns	Requires considerable tooth reduction (irreversible loss of usually all enamel and supporting teeth) and risk of pulp death requiring root canal therapy. More difficult access for cleaning (risk of gum infection and tooth decay) Failure can mean considerable damage to supporting structures Similar cost to implants initially, however high biological cost

Designer Smiles Dental Centre: Cnr. Gerard and Winnie Streets, Sydney, NSW, Australia
Phone (02) 9953-5953 or (02) 9953-4189, Fax (02) 9953-4358
Cremorne 2090 Hours 7:15AM-6:00PM, M to F