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Video: Full Mouth Dentures

Full Mouth Dentures

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.

Terminal upper dentition

Terminal Upper Dentition

Initial Presentation

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.

Terminal upper dentition under without prosthesis

Without prosthesis

Old full mouth dentures

With prosthesis

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.

Terminal upper dentition old smile front

Failing upper arch shape and smile line

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.

Terminal upper dentition right side

Note Upper arch: broken-down dentition, discoloured crown margins, unnatural teeth: colour, form, progression and gum line.

Endentulous lower arch

Lower arch: edentulous

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.

Treatment

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.

Old denture and new denture comparrison

Old dentures (left), new dentures (right)

Old denture and new denture height comparrison

Denture height comparrison

Procedure & Results

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.

Full mouth dentures phase 1

Provisional phase 1

Upper partial denture with new lower complete denture at a correct facial height.

Full mouth dentures phase 2

Provisional phase 2

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.

Full mouth dentures final smile

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

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