Case Study – 18 Vicki

Failed aesthetics: failing crowns and bridgework affecting patients comfort, function and aesthetics. This is further compounded by the presence of high smile line. Treatment: reconstruction of maxilla (upper arch)and mandible (lower arch) using tooth supported and implant supported crowns and site augmentation (soft and hard tissue grafting) where teeth have failed that require removal.

Case Study – 18 Vicki

Dental facelift: Case Study

Failed aesthetics: failing crowns and bridgework affecting patients comfort, function and aesthetics. This is further compounded by the presence of high smile line.
Treatment: reconstruction of maxilla (upper arch)and mandible (lower arch) using tooth supported and implant supported crowns and site augmentation (soft and hard tissue grafting) where teeth have failed that require removal.

This study will show

Complexity of treatment
Treatment outcome
Patient’s assessment

INITIAL PRESENTATION

Mrs. V was referred by her dentist, seeking specialist’s opinion and treatment in relation to fixed option of replacing failing but well maintained fixed crowns and bridgework

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

NoteUpper arch

Minimal tooth display during rest and speech
Canted smile line
Unnatural smile line
During smile & speech dynamics showing discoloured and failing restorations: fillings, veneers, crowns & bridgework
Reduced upper lip support

NoteLower arch

Worn upper & lower front teeth
Step in lower left quadrant
Discoloured and failing restorations: fillings, veneers, crowns & bridgework

step

DIAGNOSIS

Diagnosis: Unacceptable dental aesthetics & function due dissatisfaction with failing fixed restorations and general discolourationincluding an uneven occlusal plane: creating a perceived aesthetic disturbance

Our Aim: to improve the aesthetics of occlusal plane (canted smile line),tooth shape, display, tooth colour, length, symmetry and smile line in general, as well replacing existing crowns and bridgework.

This was accomplished with minimal discomfort to the patient and Mrs. V. Never left the practice without missing teeth. The provisional bridgework as both aesthetic and function (please Videos provided).

Diagnosis: Unacceptable dental aesthetics & fucntion due dissatisfaction with failing fixed restorations and general tooth discolouration

Our Aim: to improve the aesthetics of upper arch: Tooth shape, display, tooth colour, length, symmetry and smile line in general, as well replacing missing teeth:23,24,14,16 using implant supported crowns and replacing existing faulty crowns with new ceramic crowns.

This was accomplished with minimal discomfort to the patient and Mrs. T. Never left the practice without missing teeth. The provisional bridgework as both aesthetic and function (please Videos provided).

step

TREATMENT

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

No treatment: this is not an option as the restorations are failing and affecting longevity of supporting teeth
Repair existing restorations and make removable partial denture: this is a temporary measure and not accepted by the patient
Fixed option: tooth supported crowns and bridgework, described below

Placement of provisional crowns and bridgework

Finalize the treatment with implant and tooth supported crowns and bridgework in the upper arch.The Provisional restorations for that important confidence for normative function comfort & aesthetics

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

Clinical: Reconstruction of upper& lower arches: using tooth supported porcelain veneers, crowns and bridgework

step

PROCEDURE &RESULTS

Upper arch only completed at this stage, see next page

Smile completed using combination of porcelain veneers. Crowns and bridgework

Note the difference in shade between the arches.

Therefore, in most cases involving such a high level of reconstruction we need to consider both arches to create that level of high aesthetics and function as requested by this elegant patient

Completion of both arches

Creating symmetry & harmony by levelling the smile line, improving: arch form tooth formcolour, and display

Smile completed using combination of porcelain veneers. Crowns and bridgework

Porcelain veneers placed on upper and lower front six teeth

Crowns and bridges on the back teeth

STEP

What our Clients Say!

I've been a customer of Designer Smiles for over 20 years and I cannot say enough good things about them! From the moment you walk into the office, you are greeted with a warm and friendly atmosphere that immediately puts you at ease. The staff is knowledgeable, professional, and caring. They use the latest technology and take the time to explain everything. I highly recommend them!

Ken Baumli

Dr Sarkis is the maestro of cosmetic dentistry….for years I suffered with 2 slightly darker front teeth due to a childhood accident. I’ve had composite veneers before but nothing compared to the composite veneers Dr Sarkis did……now I feel so confident smiling again……Dr Sarkis I can’t thank you enough…

Monica McKenzie

Quite literally the best dentist I’ve been to in a lifetime. Dr Natasha Koelmeyer specifically is just a wonderfully kind and gentle Doctor. Must also mention that the head specialist here is also second to none. Their knowledge (goodness they know their stuff) their approach, their kind and gentle manner - my daughter actually enjoys going to the dentist. They’ve got a really considered patient centric mentality. I wouldn’t go anywhere else, every single person there including the reception staff is a star. Thank you Designer Smiles!

Michelle Lacasse

My journey with Dr Sarkis began about 10 years ago. I did not realise that I had lacked self confidence and shone away from "my true smile". Dr Sarkis was honest, reassuring and professional throughout my process and not only was he able to achieve that perfect smile but achieve same without compromising the health of my teeth and gums.The ongoing care at Designer Smiles is 5 star whether it is a routine check, clean minor or major dentistry. Thank you Dr Sarkis and also your team.

Christina Vergotis

I found Designer Smiles from one of their YouTube videos showcasing the Icon treatment to fix white spots on teeth. Dr. Sarkis Nalbandian's consultation provided me with a thorough plan and showed me how their practise could give me predicable results for my concerns. I knew I was in safe hands. I had Kristy Gupta perform both of my procedures and she was very professional and so kind. I am very happy with my results!

Winsome Kain

I cannot express how grateful I am for Sarkis and the team at Designer Smiles. Around 11 years ago my life changed when Sarkis first transformed my smile with composite veneers. This month, with my original teeth in tact I returned to have my composite veneers upgraded to porcelain. I was amazed that Sarkis and his team could do this without an injections, no pain and whilst still keeping my original teeth in tact. I absolutely love the result and I would highly recommend that anyone that is unhappy with their smile in any way, must visit designer smiles

Matt Williams

Started my treatment with the team at Designer Smiles in 2019. Had other dental treatments including Maxillofacial, expanders, straightening and gum grafting but out of all the procedures and surgeries Dr. Sarkis was the key as he was applying the ‘finishing product’ which included composite veneers. I am gobsmacked by the incredible job done. He talks the talk and definitely walks the walk. And his support team there are simply incredible and make you feel part of a family not just another dental clinic to take your money. Can not recommend highly enough. Customer for life here!!

Shaun Meader

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