Patient PP 60 years old, was unhappy with the appearance of her teeth, and difficulty to eat as she was missing all her lower back teeth. She has attempted a few dentures on the lowers to replace the missing teeth but she has Sjogren's syndrome, (reduced saliva / dry mouth) and so could not tolerate a denture.
We decided to improve her smile with crowns on all her upper teeth as veneers are not an option for a person who is a bruxist (grind /clench their teeth), and lower teeth we built up with composite (white filling) and 2 implants on either side to help the patient eat properly.
The patient was thrilled with the result.
Before Treatment
Wax up and Mockup in the patient for consent and accepting the final result
Surgical Phase - Stage 1- Implant placement with surgical guide - Lower premolars.
The surgical guide used to guide during surgery, short implants were used. Astra tech 3.5 mm implants of 6mm and 8 mm were used due to the close proximity to the nerves.
Surgical Phase - Stage 2 - Placing healing abutment after 3 months of stage 1 for gum shaping before impressions.
Provisional -Lower implant impression and restoration
Provisional Phase - Upper teeth preparation and restorations with PMMA crowns
All teeth were prepared in stages, then temporaries placed on them, then converted to lab-made provisional after an impression. Left in the mouth for 4-5 months to access any loss of vitality/bruxism control.
Definitive Preparation and Impression- Upper
After Treatment - Upper crowns Metal Ceramic , lower anterior composite to close spaces in between and premolar as linked implant bridges.
This was one of the cases I submitted for my MPros exam by RCS,Edinburgh, if anyone is keen on understanding the case better or to see how cases are usually presented for MPros - kindly follow the link for the dropbox for details of the case.