A dental facelift is when your smile acts as a canvas to change the aesthetics of your face.
In this study the issues that improved the patient’s facial aesthetics and proportions were; failing crowns and bridgework affecting patients’ comfort, function and aesthetics. The presence of a high smile line further compounded this.
Treatment: reconstruction of the maxilla (upper arch) using tooth-supported and implant-supported crowns and site augmentation (soft and hard tissue grafting).
The patient was referred by her dentist, seeking a specialist's opinion and treatment concerning the fixed option of restoring missing teeth, failing dentition, and tooth-supported crowns. The loss of teeth from failing bridgework has left significant soft and hard tissue defects that required augmentation to create a base for tooth replacement.
In general, 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.
When this is difficult, we use pink porcelain to simulate gum aesthetics. In many ways, pink porcelain veneers are more predictable than extensive grafting procedures, depending on the cases treated.
Chief concerns: improving the aesthetic appearance of her smile. The situation is to improve the upper arch shape, smile line, and tooth colour. This lovely patient wants to smile and chew her food confidently. The patient was concerned explicitly about recent dental work by another dentist, causing protrusion and canting of upper central incisors creating an aesthetic disturbance, lip incompetence and speech impediment.
Note the canter midline and unnatural teeth: colour, form, progression & gum line.
Note that a provisional removable prosthesis replaced the ridge defect in the critical aesthetic zone. This site required surgical augmentation before Dental implant placement. This allows the implant to be placed in the correct direction for optimal construction and emergence profile of the final crowns and bridgework.
Our aim: to improve the aesthetics of the upper arch: Tooth shape, display, tooth colour, length, symmetry and smile line in general, as well as 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 temporary bridgework is aesthetic and functional (please see the Videos provided).
The provisional restorations for that necessary confidence for normative function comfort & aesthetics.
- Followed by a discussion of all risks and treatment modalities with our patient, included
No treatment: this is not an option, as the restorations are failing and affecting the longevity of supporting teeth
- Repair existing restorations and make removable partial dentures: this is a temporary measure and not accepted by the patient.
- Fixed option: implant & tooth-supported crowns and bridgework, described below. Removal of failing bridgework
Placement of provisional crowns and bridgework
- Arrangement of implants at sites: 22,23,14 & 16
- Finalize the treatment with implant and tooth-supported crowns and bridgework in the upper arch.
The work was completed in six months as it takes this long for grafts (a bit longer) and implants to integrate with the bone. It is best not to rush biology and allow optimal healing.
The provisional restorations provided the necessary confidence for our patient for normative function comfort & aesthetics. We tested the new temporary repairs and refined them for patient acceptance, guided for the final desired aesthetic outcome.
Final treatment outcome: we have restored esthetics comfort & function, and we have a happy patient
Unfortunately, this work was initially completed by a dentist with minimal qualifications and experience. Hence, the patient seeked a specialist prosthodontist for correct diagnosis and treatment planning, providing an optimal outcome for this lovely patient.
Note improvement in lip thickness & support in combination with correcting protruding maxillary central incisors
Final treatment outcome: we have restored aesthetics, comfort & function.
However, most importantly, we have complemented our lovely patient's facial aesthetics.
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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!
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…
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!
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.
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!
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
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!!