Issue: He was concerned about the extreme amount of tooth wear he had noticed over time. Significant enamel loss had created teeth that were shorter than they should be, rough on the edges, and sensitive to foods and temperatures. The broken down shape of the back teeth had also created an inability for him to find a comfortable and repeatable bite position, which accelerated the wear and chipping.
Solution: A diagnostic plan was developed to relax his muscles, find a new bite position, and rebuild the damaged teeth to a place that was comfortable and capable of functioning without repeating the damage of the past. This view shows the completed upper arch with e.max crowns on every tooth. The bottom arch has yet to be completed and the back teeth have long term provisionals on the top of them to keep him stable in his new bite position until the lower teeth can all be crowned as well.
Issue: Discolored natural teeth, mismatched materials and colors of previous dental work, uneven lengths of side front teeth, cavities along the gum line of lower teeth.
Solution: A diagnostic plan was developed to completely restore the appearance and function of her teeth. New crowns of a consistent color and proper length were placed on each tooth after the removal of cavities and failing past work.
Issue: Several missing back teeth on both sides making it difficult to chew, significant tooth wear and enamel loss, and a mismatch of materials and colors that created a smile he was not pleasing to him.
Solution: Diagnostic planning to find a comfortable position for him that allowed teeth to be lengthened and missing teeth replaced. Bone grafting and implants placed to replace missing teeth and new zirconia crowns on all upper and lower teeth.
Issue: Advanced periodontal disease, multiple missing teeth, and several abscessed remaining teeth.
Solution: All remaining teeth were removed and a digitally guided All-On-X approach was used to place implants and immediate teeth all in one day. Four implants were placed in the upper jaw and six were placed in the lower jaw and the prostheses were attached to the implants, creating a completely stable and non-removable option for the patient. After healing, permanent zirconia prostheses were designed and attached to the implants to completely restore her mouth and smile. This treatment option allowed her to to create the confidence of the healthy smile she wanted while eliminating the risk of continued gum disease, cavities, and tooth pain.
Issue: Long term breakdown of oral health had resulted in a smile she was not confident with anymore. Multiple missing, broken, and infected teeth were present, creating a situation that did not make sense from a risk or financial perspective to rebuild from while keeping natural teeth.
Solution: All remaining teeth were removed and an All-On-X approach was used to restore the upper teeth with a zirconia hybrid attached to six implants. An overdenture attached to two implants in the canine positions was used to replace the lower teeth. This option resulted in the combination of a non-removable upper prosthesis and a more economical removable lower overdenture, allowing her to create the smile and confidence she wanted while remaining within her budget.
Issue: She was unhappy with the color variations between different areas of dental work and her natural teeth, the unnatural appearance of the upper left front tooth bridge, and was suffering from muscle and joint pain.
Solution: A deprogrammer was used to improve the muscle and joint pain while developing a new, more comfortable bite position. New zirconia crowns and bridges were placed to create the color consistency and natural appearance she desired, while at the same time allowing her to function without the pain caused by her old bite.
Issue: Severely compromised remaining natural teeth with multiple areas of decay, failing previous dental work, missing teeth, unaesthetically restored lower front implants, and extremely worn and chipped upper front teeth.
Solution: Through a detailed plan of bone grafting, implant placement, and new crowns on the remaining natural teeth – a dramatic restoration of function and cosmetic appearance was possible.
Issue: She was concerned about the continued loss of enamel that was becoming more noticeable on her back teeth as well as the chipping edges of her front teeth. Back teeth were becoming sensitive and she wanted to replace the missing molars as well. The nightguard she had been prescribed by a previous dentist was not stopping her teeth from wearing down and chipping so she wanted to fix the cause of the problem rather than treating just the symptoms.
Solution: A diagnostic plan was developed to replace missing teeth and improve her bite and function. This allowed us to rebuild the damaged teeth in a way that they could work together and not continue to chip and break down. This also allowed the teeth to be brightened and create the other changes to her smile she desired – check out the before and after changes in the chewing surfaces of the teeth in our Full Mouth Rehabilitation section.
Issue: Multiple missing teeth, cavities under existing crowns, an uneven bite, and infected lower front implants.
Solution: New crowns, bridges, and implants were used to completely restore his upper teeth. The lower teeth and failing implants were all removed, four new implants were placed, and an All On 4 hybrid denture was attached to the implants to completely restore his lower teeth.
Issue: New cavities around older fillings and crowns, dark natural teeth, and mismatched colors of existing dental work had all created a smile she wasn’t happy with.
Solution: A lower front tooth was removed, Invisalign was used to expand the narrow arches and reposition teeth into more ideal positions, and new crowns were placed over all remaining teeth to create a healthy, beautiful smile.
Issue: Years of an dysfunctional bite and grinding habits led to jaw pain and significantly worn down and broken teeth. She wanted to recreate a more youthful smile while repairing the damage and getting rid of her TMJ pain.
Solution: A deprogrammer was used to relax her muscles and find a comfortable position to rebuilt her bite into. A new mock up was made for restoring the teeth and long term provisionals were copied from that design placed on the back teeth to confirm her comfort with the changes. Once that was confirmed, the full mouth placement of e.max over zirconia crowns was completed.
Issue: Multiple missing teeth and several of the remaining teeth were infected and painful or broken and non restorable. She wanted a non-removable solution that would recreate her ability to smile confidently and chew comfortably.
Solution: A fully digital All-on-X treatment plan was developed to remove all the remaining teeth, place six implants in the top jaw and four implants in the bottom jaw, and attach a new set of teeth to them all in the same appointment. After 4 months of healing, the process was started to create new upper and lower zirconia hybrid dentures which attach to the healed implants.
Issue: She was bothered with the display of metal and dark roots under old crowns on the lower front teeth. A comprehensive exam also revealed an infected implant, a dysfunctional bite, and several areas of decay along the gum line under old crowns.
Solution: A full mouth restoration after deprogramming and relaxing her muscles to get a level and functionally proper bite. Crown lengthening was performed to even the gum line along her top front teeth, a non –restorable tooth on her lower left was replaced with an implant, and new crowns were placed on all remaining natural teeth and implants on the upper back teeth to repair the cavities, level both arches, and cover the teeth to the gum line so no undesirable color transitions were visible.
Issue: Missing teeth, visible roots above front crowns, and upper front teeth closing behind the lower front teeth. He wanted a natural looking smile and to laugh without concern of how his teeth looked.
Solution: The combination of tooth loss and positioning of remaining teeth made it impossible to satisfy his goals and keep the upper teeth at the same time. Braces were placed on the lower teeth to improve positioning, the upper teeth were removed, six implants were placed, and a zirconia hybrid was secured in place on the implants.
Issue: A broken and discolored lower front tooth with an infected root canal was becoming symptomatic and she did not like the appearance of it. Consistent wear and chipping across the tops of the front four lower teeth was also becoming concerning.
Solution: A diagnostic plan was put in place to functionally change the way her teeth bite together, eliminating the cause of the lower wear and chipping. This involved making her back teeth taller with conservative bonded onlays and restoring the implant on the lower left. The discolored front tooth was then extracted and a bridge and new crowns were placed to restore the cosmetic appearance she desired.
Issue: Multiple failed rounds of restoring natural teeth with crowns and root canals had left Karen frustrated that problems were continually developing.
Solution: After detailed planning and lengthy discussion, she decided removing her natural teeth and replacing them with implant-supported hybrid dentures was her best option. Multiple implants were placed in her upper and lower arches and beautiful, custom prostheses were fabricated to securely attach to those implants. The result was a brilliant smile, a perfect functional bite, and completely secured prostheses that cannot become loose on their own.