Compare aging with decreasing lower face height

After loss of teeth, the support (scaffolding) for the facial musculature almost disappears depending on patient’s genetic factors. No amount of plastic surgery can restore the facial tissues, since the bony scaffolding (teeth and supporting bone) is not present (atrophied). To restore these soft and hard tissues, the best option provided bone volume is present, is implant supported bridgework or over-dentures.

Most patients prefer implant supported bridgework because psychologically it is your teeth fixed to your “head”. This is particularly evident during intimate moments with your partner when embarrassing tooth movement no longer occurs once the fixed implant bridge has been completed. My patients have commented on this aspect of their lives (with much excitement) both before and after their fixed implant bridgework was completed and tested!

There is lot more than just biting on an apple with confidence!Enjoy life with confidence and a little help from us.

That will guide our team in achieving optimal dentofacial aesthetics. This procedure takes time and experience.

This is accelerated aging

So how do we start the dentofacial rejuvenation?

1. Let’s look at the aging process of lower facial height.
2. Do notice how the nose and chin are closer together after the teeth loss?
3. Which facial profiles would you prefer?The one on the left or the one on the right?
4. Which facial profile is more youthful?

The reason Dr Nalbandian is asking these questions is because it is all about the facial harmony and not the teeth. We set the teeth to fit the face. Therefore we work backwards from the face to the lips then to the upper arch position and finally the set of teeth. The diagnostic assessment is essential.

Note the loss of teeth causes accelerated aging in this diagram.

This accelerated aging can happen at any age with loss of teeth. We refer to this as a facial atrophy.

Accelerated teethwear can also result in reduced lower facial height (refer to menu on worn smile and smile rejuvenation).

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Facial atrophy

When anterior teeth are lost on the right the facial curtain hangs straight down from lower border of the orbit, and the smooth curtain from the side of the upper lip to the cheek is interrupted by an extension of nasolabial groove. Increased facial folding with loss of lower facial height

Loss of VDO-lower facial height

Loss of upper lip support

Thinning and retraction of upper lip

Accelerated aging effect

Our treatment is directed at reversing the aging effect as staged in these diagrams.

Note the stages of progress in treatment towards dentofacial rejuvenation using cosmetic denture and implant supported lower fixed bridge.

AGING

• Eyes and mouth
• Bones shrink with age
• Changes in volume around mouth and eyes
• Loss of volume results in premature aging, unilaterally worse
• Need to increase the facial volume, decrease the wrinkles and folds
• Tooth extractions result in the loss of bone structure
• The face – genetic + environmental
• Speech and expressions

There remains a capacity for remodelling the ones of the face at any age (Enlow)

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NEUROPLASTICITY

Testing patient’s adaptation and tolerance level -NEUROPLASTICITY

Provisional upper denture and the terminal lower teeth employed to initially restore the patient’s facial height and upper lip profile as much as possible. This takes considerable perseverance from the patient, but it works!

The lower teeth were removed and porcelain implant supported bridgework constructed and issued.

Three months later patient is able to adapt to the new facial height. Speech and comfort have improved dramatically, and aesthetics and confidence is immense.

Whenever possible we would like to improve on the final work. After all it is all about our patients’wellbeing.

We have finally restored the confidence and wellbeing of this elegant lady.

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One Smile says it all!

Patients do not want implants they want comfort, to be able chew their favourite food and smile with confidence.All above procedures were performed by Dr Sarkis Nalbandian.Education and Experience are everything.Designer Smiles® is The centre for  implant, surgical and reconstructive (prosthodontic) oral rehabilitation solutions.