Terminal upper dentition. Patient requesting full dentures. Not all patients want implants. This lovely patient has had full lower dentures for some time and has coped well. Since the upper teeth are failing the request was made for new dentures.
We have unacceptable aesthetics and function. It’s surprising to see how much patients can tolerate with broken down dentition. I guess we are all are busy in our lives, looking after the family and finally when everyone is ok, it time for us.
This study will show:
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 difficult 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 a specialist’s opinion and treatment in relation to full dentures on both jaws. With time she has lost facial height. She specifically requested removable dentures and this is okay 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 we 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.
Note Upper arch: broken-down dentition, discoloured crown margins, unnatural teeth: colour, form, progression and gum line.
Diagnosis: Unacceptable dental aesthetics and fucntion 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:
Laboratory: Reconstruction of upper arch: implant supported bridgework and tooth supported crowns.
Clinical: Reconstruction of upper arch: implant supported bridgework and tooth supported crowns.
Maxillary and mandibular treatment 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.
Upper partial denture with new lower complete denture at a correct facial height.
Construction and issue of new upper and lower complete dentures incorporating al the original tooth colour form: providing youthful smile for this lovely patient. Patient presented images of her age 25yrs and these were copied in the final design. Note improvement in lip thickness and 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.
Thank you for taking the time to explore this patient’s story. I hope this gives you an idea of what I can do for you if you are having difficulty and need help, because there is always hope.
Dr. Sarkis Nalbandian
Visiting Professor YSMU
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) FIADE, FPFA