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Designer Smiles Dentistry

Complex Prosthetics and Dental Rehabilitation – Patient Story

Dental facelift: Rehabilitation of partially edentulous maxilla and mandible case study. The patient presented with a family history of osteoporosis. In 2001, diagnosed and treated with bisphosphonates. Unfortunately for this healthy patient following treatment with Fosamax, bisphosphonate related osteonecrosis and severe intractable oro-facial pain required removal of teeth and segmental mandibular osteotomy: 46 – 32 by oral and maxillofacial surgeon.

Complex Prosthetics and Dental Rehabilitation – Patient Story

Dental facelift: Rehabilitation of partially edentulous maxilla and mandible case study. The patient presented with a family history of osteoporosis. In 2001, diagnosed and treated with bisphosphonates. Unfortunately for this healthy patient following treatment with Fosamax, bisphosphonate related osteonecrosis and severe intractable oro-facial pain required removal of teeth and segmental mandibular osteotomy: 46 – 32 by oral and maxillofacial surgeon.
Model

Complex Prosthetics and Dental Rehabilitation – Patient Story

Dental facelift: Rehabilitation of partially edentulous maxilla and mandible case study. The patient presented with a family history of osteoporosis. In 2001, diagnosed and treated with bisphosphonates.

Unfortunately for this healthy patient following treatment with Fosamax, bisphosphonate related osteonecrosis and severe intractable oro-facial pain required removal of teeth and segmental mandibular osteotomy: 46 – 32 by oral and maxillofacial surgeon. Implant replacement is not an option since risk of osteonecrosis is very high.

The oral and maxillofacial surgeon did lifesaving, wonderful work for this most lovely and gracious patient, who has been through so much pain, discomfort and misery as a result of MRONJ

CHIEF CONCERNS
  • “I want to smile and chew better”
  • Improve confidence
  • Pain on lower chin from pressure
  • See the history below
  • Removable prosthetic solution as implants are contraindicated
  • Cost is always a concern

This study will show

  • Complexity of treatment
  • Treatment outcome
  • Patient’s assessment
  • Please refer to the video provided

step
1
INITIAL PRESENTATION

Reduced lower right lip and cheek support due to missing 46 – 32: affecting comfort, function symmetry and aesthetics

Diagnosis: With a history of MRONJ and segmental mandibular osteotomy, patient is dissatisfied with reduced masticatory efficiency causing: phonetic, functional and aesthetic disturbance

Our Aim: to improve; phonetics, comfort, function and aesthetics the aesthetics to provide, most importantly, confidence for this delightful patient.

This was accomplished with minimal discomfort to the patient and she never left the practice with missing teeth. The provisional teeth for optimal aesthetics and function.

step
2
TREATMENT

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

  1. No treatment: this is not an option
  2. Fixed option is contraindicated as we have a history of MRONJ (medication induced osteonecrosis) – accepted by the patient

step
3
PROCEDURE & RESULTS

Lower arch: The lower precision fitted partial denture simply disappears in the mouth: restoring missing hard, soft and dental (teeth) tissues.

Clinical: Reconstruction of upper arch: replacing existing crowns and bridgework and providing special milled crowns to provide special support and stability for lower precision fitting Chrome -cobalt partial prosthesis (denture).

Laboratory: Reconstruction of upper arch: Tooth supported crowns replacing existing crowns and bridgework.

step
4
FINAL TREATMENT OUTCOME

We have restored aesthetics comfort & function.

However most importantly we have complemented our lovely patient’s facial aesthetics.

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

Final treatment outcome: we have restored esthetics comfort & function and we have a happy patient with confidence.

step
5

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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