Failed aesthetics: failing veneers, crowns and bridgework affecting patients comfort, function and aesthetics. This is further compounded by the presence of dark spaces in the lower arch with asymmetric lower lip deflection. Treatment: reconstruction of maxilla (upper arch)and mandible (lower arch) using tooth supported veneers, crowns and bridgework.
Discoloured porcelain veneers and dark triangles
This study will show:
Reduced upper lip support
Chief concerns: improving the aesthetic apperance of her smile. The concern is to improve the upper arch shape and smile line as well as tooth colour. This lovely patient wants to smile with confidence.
Patient was referred by her dentist, seeking specialist’s opinion and treatment in relation to fixed option of restoring missing teeth and failing dentition as well as tooth supported crowns. The loss of teeth from failing bridgework has left considerable soft and hard tissue defect that required augmentation to create base for tooth replacement. Since the existing design of the crowns and bridgework has served well last 20 years, we decided to replace the restorations and improve on the design, using only tooth supported bridgework as there was no need to complicate the treatment and increase the costs by dental implants.
Dark spaces as edentulous ridges have undergone resorption over time: causing food impaction. The existing restorations have been repaired subsequently. Porcelain veneers have been recemented a number of times. We have unacceptable aesthetics. In general, whenever possible we would like to replace, or at least get close to the foundation bone and gum tissues to allow optimal tooth position in the arch that creates natural aesthetics.
Unacceptable dental aesthetics due dissatisfaction with failing fixed restorations and general tooth discolouration. Our Aim: to improve the aesthetics of both arches: Tooth shape, display, tooth colour, length, symmetry and smile line in general, replacing existing veneers and crowns with new porcelain technology.
This was accomplished with minimal discomfort to the patient and Mrs. M. never left the practice with missing teeth. The provisional restorations constructed were instrumental in final aesthetic and functional outcome.
Following with discussion of all risks and treatment modalities with our patient that included:
The work was completed in two months. Provisional restorations Mrs M approving the colour and shape. Note improvement in smile line, lip outline, support and thickness. Final treatment outcome: we have restored esthetics comfort and function and we have a happy patient.
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