Note how the implant crowns emerge from the gum.

We not only have the implants integrating with the bone but soft tissue integration is also achieved. We have achieved an aesthetic Integration.

Restoring the anatomy: mimesis-imitating nature (Aristotle)

Note how the implant crowns emerge from the gum.

We not only have the implants integrating with the bone but we have achieved an aesthetic Integration.

Dr Nalbandian has discussed the complexity of the treatment in detail. Patient also followed all the instructions outlined, so we can achieve a favourable outcome.

This elegant result can only be achieved by a realistic patient who has a realistic expectation. The complexity of the case as discussed in detail:

Patient to quit smoking and maintained regular professional hygiene and home care.

High smile line with complex smile dynamics, where everything is on the show is a most difficult aesthetic dilemma to reconstruct, especially where dental implants are required.

We thank our patient for her commitment to achieve an optimal aesthetic, comfort and function.

X-rays showing the position of the implants in both jaws with optimal bone support. Planning for success is not always simple and depends on the dentist, patient and most importantly the BIOLOGY. Achieving that level of aesthetics is complex, but not impossible. In summary, prosthodontics requires the training and qualification to deal with complex dental health problems. Dr Nalbandian has attended an internationally recognised and formally structured university program to give him the extra skill and knowledge required to plan and manage complex dental problems. The qualification takes several years of training and practice. This has been over 7 years of post-graduate University training, multiple examinations etc. For instance, rather than simply providing cosmetic solutions, which after all, only focus on “how things look”, he is trained to correctly diagnose and treat any underlying problems beforehand. This concept is carried over into all aspects of reconstructing or improving smiles and appearances, including fixed or removable teeth, giving the patient a long-term result rather than a “quick fix” which might break down early or even damage the teeth. The implant surgery involves additional skills obtained for surgical planning and placement of dental implants as an overall diagnosis and treatment for our patients. To gain any formal post graduate qualification, one must have their relevant knowledge tested in any examination or pass any professional critical review process at world class universities. In other words, doing 2-day motel course does not make a dentist an implantologist or an expert in reconstructive dentistry. Dr Sarkis Nalbandian is a Specialist Prosthodontist and an Implant Surgeon. This dual qualification helps the patients to have both implant placement and reconstructions completed in one roof with reduced costs. Our diagnostic centre is unique and you the patient can have all the relevant diagnostic information in one centre at Cremorne. Our referring dental colleagues like this because their patients are looked after in one centre and by a specialist who cares about his patients just like his own family.

The Bride is Ready!

Pleasant aesthetic achieved for this beautiful patient.

Magnification

The uses of operating microscopes for prevention and maintenance in reconstructive dentistry are four-fold:

1. Following insertion of restorations, there is the advantage of being able to track any problems by periodic video examinations utilizing the intraoral camera. Visible and sometimes invisible potential marginal problems can be greatly enlarged. Certainly, the ability to diagnose and treat a defective margin as early as possible can prolong both the aesthetic and functional life of restorations.
2. Patients cannot see for themselves what we can see; thus, highly enlarged views made available by operating microscopes enhance patient compliance in home care. Typically, patients wait until something is sensitive before seeking treatment. Periodic examinations utilizing the intraoral camera can play a significant role in prevention of inevitable aesthetic failure due to marginal pathology.Operating microscopes can and should also be used to show patients areas of their mouths that lack proper hygiene maintenance. For example, enlarged lingual views give patients the opportunity to see the inside of their mouths like never before.
3. One of the most frequent causes of restoration failure is lack of gingival hygiene, with both flossing and brushing. When images of the mouth are magnified while the explorer is used to remove plaque from the sulcus, patients become visually aware of the importance of ongoing maintenance. Restoration longevity is normally expressed in averages. For instance, full crowns is 5 to 15 years. However, a patient should be aware that not even the normal range of life expectancy will be achieved unless these gingival areas are maintained on a daily basis.
4. Operating microscopes are also highly useful in showing patients existing micro cracks. These micro cracks (in teeth and restorations or crowns with less than ideal marginal integrity) can stain and cause other aesthetic problems for patients. Photographs and permanent records of these micro cracks can be of tremendous benefit to the patient in accident cases. Documentation of micro cracks also provides a baseline for assessing subsequent staining or changes.   Link to cracked teeth
5. The intraoral camera can be used to magnify and photograph areas of obvious bruxism. Identify problems at subclinical stages before it is recognised clinically by the patient who has persistent discomfort. 

Dr Nalbandian uses special Leica ® operating microscopes due to the delicate nature of his work. Magnifications at 10 x plus improve accuracy and comfort to our patients saving a multitude of problems later on.

Children also visit our practice as we also cater for the whole family. Dental visits are fun and educational and children’s curiosity is amazing. Our staff are highly trained in today’s multifaceted and sophisticated dental care.

Experience and post graduate training is mandatory for thorough diagnosis and treatment planning to deliver high quality care to our patients.

Our practice provides a full range of diagnostic services including digital x-rays, OPG’s and CT (CAT SCAN).  It is a one stop shop for all dental needs from simple to full mouth rehabilitation using tooth or implant supported restorations.

Diagnostics:

1. Benefits the patient
2. Immediate diagnostic information for the patient and the dentist
3. Saves crucial time in your busy life
4. We can also diagnose other dental concerns at the same time as the scan sees all the structures around the teeth, jaws and face

Dental implant supported teeth require additional expertise, because the patient does not want a titanium screw in their mouth, they want teeth! It is all about the patient. Dr Nalbandian has placed and treated thousands of patients from single teeth to complex full mouth implant supported bridgeworks. Our centre is equipped with state of the art diagnostic facilities (CT scans, digital x-rays & imaging). His dual specialised qualifications in both implant surgery and prosthodontics (oral reconstruction) helps the patients complete all the procedures in “one stop shop”, which save time and the cost of the delivery of the treatment. This is also a referral practice from other dental surgeons for complex implant reconstructive & cosmetic cases.

Link to Scanora PDF and comparable Radiation Data ( provide a link) for  our Cone Beam CT (CBCT)

Integrating Cone Beam CT in my practice over 10 years

This has provided my practice with the convenience of having diagnostic information at my fingertips and I have been very happy with this system. Patients are happy to not be referred elsewhere for radiography.

Today time is an issue, not only for the patient but also for the dentist.

The CBCT available today has a much reduced radiation level and produces images which are clear and software friendly to use. Patients appreciate seeing their CT images on the screen immediately and are thrilled to be involved in their diagnosis and treatment planning. This has become a standard of care in the diagnosis and consenting process today.

Our diagnostic information not only requires simple assessment in 2D, especially in my practice of Implant Surgery and Prosthodontics, but in 3D where immediate diagnosis is required. This information is crucial to patient treatment especially those travelling long distances to come to our practice.

Having 3D images and the ability to reformat in different sections is immensely valuable to diagnosis and aids in all disciplines of dentistry. In my practice I need information NOW! And can get this NOW!

The new Scanora 3D helps me taking CBCT (cone beam CT) and sending the copies of the CD to my referring dentists for continual care of their patients. It is also very valuable when referring to colleagues such as ENT surgeons, OMF surgeons and orthodontics.

The diagnostic information obtained from CBCT in many ways depends on your treatment requirements and diagnostic assessment.

Here are some of the points worth mentioning:

1. Prosthodontic and Implant Surgery: 3D, reslicing at any angles, nerve tracking, and 3D guided surgery applications, panoramic images that are second to none. TMJ provides the anterior and laboured views.
2. Periodontics: assessing amount of bone support in 3D-this visual process is the best diagnostic and essential for patient education. Patients do not understand periodontal charting and plaque scores, but can see the bone loss, tooth migration and over eruption in the 3D image.
3. Orthodontics: orthodontic diagnosis in 3D, Cephalometric in with 3D analysis, superimposition: measuring/comparing tooth movement, pre/post orthodontic measurement, volumetric space change etc. This combined with 3D imaging will change the face of orthodontics. Assessment during orthodontic treatment for implant surgery and grafting. Small tooth movements in simple tooth movements using TAD (temporary device anchorage).
4. Sleep Apnoea/anti snoring adjunct diagnosis and therapy. Measuring 3D volumetric space: the physical airway, video viewing, and excellence in patient education.
5. The Scanora 3D is two systems in one, with true digital panoramic and low dose CBCT with four different fields of view.

Having this information at your fingertips is Gold! A new era has begun.

This is the ‘Gold Standard ‘in diagnostics.

This means our patients do not have to wait weeks for correct diagnosis and treatment planning, when most of the time this is done immediately, since the information is on the screen.

Special diagnostic measures such as composite mock-ups (trial restorations) help the patient to visualise their results from simple aesthetic to complex reconstructive procedures. It is all about helping our patient in communicating all steps of the required procedures.