Designer Smiles
Dental facelift: Case Study Terminal upper dentition. A patient requesting full dentures

Terminal upper dentition. Patient requesting full dentures.

Not all patients want implants. This lovely patient has full lower dentures for some time and has coped well. Since the upper teeth are failing the request was made for new dentures.

Initial Presentation

We have unacceptable aesthetics and function. Its surprising to see how much patients can tolerate with broken down dentition. I guess we all are busy in our lives, looking after the family and finally when everyone is ok, it time for us.

This study will show

  • Complexity of treatment
  • Treatment outcome
  • Patient’s assessment
  • Please refer to the video provided
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Without prosthesis

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With prosthesis

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Chief concerns: improving the aesthetic apperance of her smile. The concern is to improve the upper arch shape and smile line as teeth are failing. Patient was specifically concerned about the change from upper partial dentition to full dentures. At age 70 years can be dissicult to get accustomed to new teeth. After all this lovely patient wants to smile and chew her food confidently.
Patient was referred by her dentist, seeking specialist’s opinion and treatment in relation to full dentures on both jaws. With time we have lost facial height.
Patient specifically requested removable dentures and this is Ok as an option of restoring missing teeth and failing dentition. The loss of teeth from failing bridgework has left considerable soft and hard tissue defect.
In general, whenever possible we construct new dentures would like to replace, or at least get close to the original teeth and gum colour and optimal tooth position in the arch to create natural aesthetics.

Upper arch

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Lower arch:

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Diagnosis: Unacceptable dental aesthetics & function due to dissatisfaction with failing fixed restorations and worn discoloured denture

Our Aim: to improve the aesthetics of upper arch: Tooth shape, display, tooth colour, length, symmetry and smile line in general, using provisional partial denture.
This was accomplished with minimal discomfort to the patient and Mrs. L. Never left the practice without missing teeth.


Following with discussion of all risks and treatment modalities with our patient that included 

  1. No treatment: this is not an option as the restorations are failing and affecting longevity of supporting teeth
  2. Repair existing restorations and make removable partial denture: this is a temporary measure and not accepted by the patient
  3. Transition from partial to full dentures in the upper arch with new upper and lower complete aesthetic dentures.

Laboratory: Reconstruction of upper arch: implant supported bridgework and tooth supported crowns

Clinical: Reconstruction of upper arch: implant supported bridgework and tooth supported crowns

Procedure & Results

The work was completed in six months and implants to integrate with the bone. Is best not to rush biology and allow optimal healing. Construction and issue of new upper and lower complete dentures incorporating al the original tooth colour form: providing youthful smile for this lovely patient. The patient presented images of her age 25yrs and these were copied in the final design.

Maxillary and mandibulartreatment dentures. Note how we raised the OVD-facial height with new dentures and this allow to improve the facial height giving youthful and fresher look

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Provisional phase – 1Upper partial denture with new lower complete denture at a correct facial height

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Transition: from upper partial to complete denture, incorporating the changes from the diagnostic upper partial denture

Note improvement in lip thickness & support in combination of correcting protruding maxillary central incisors

As a specialist prosthodontist my aim is helping our patients to achieve their desired aesthetics and functional outcome.

Dr. Sarkis Nalbandian

Registered Specialist   

Prosthodontist & Implant Surgeon
B.D.S. (Hons), Dip. Clin. Dent. (Oral Implants) Uni Syd, M. Clin. Dent (Prosth) King’s College, Uni London

D. Clin. Dent (Prosth) Uni Syd, FRACDS, MRACD (Prosth)

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