GE presented with maxillary and mandibular conventional complete acrylic dentures. She expressed both functional and aesthetic concerns.There were deficiencies in retention, support and stability.
The maxillary ridge was adequate, but the mandibular ridge was severely resorbed. there was loss of OVD causing angular chelitis, also associated denture hyperplasia. The denture hyperplasia in the lower ridge was quite severe with a flab on anterior flabby ridge.
The patient was treated with a new maxillary conventional complete acrylic denture and a mandibular implant-retained complete acrylic over denture
Pre Treatment Photographs
Initial treatment
Improved denture hygiene , as patient has parkinson's , advised better handle grips to help with denture cleaning brush which helped a lot . Antifungal 2% Micanazole oralmucosal gel twice a day for 10 days on the angles of the mouth and on the fit surface of the denture and the result was much improved.
On the lower dentures the anterior buccal flange was cutback and relined with ‘tissue conditioner’(Coe Comfort) and changed every week for up to 4 times.Then it was relined with soft reline(Coe-soft) until the fabrication of new dentures.
Stage 1 - Implant Placement
Surgical stent used to place implants in the LR3 and LL3 region .
Stage 2 - Implant exposure
Healing abutments put on the implants for a good gingival cuff . You can see how the gingival hyperplasia has improved with tissue conditioning and soft liners.
Locator abutments and impressions
Upper and lower secondary impression with special tray border moulding with pink wax and impregum.
Upper conventional and lower locator pick up in a closed tray technique.
Post Treatment Photograph
Patient wanted a natural smile , and copy the patient's natural teeth with an overlap of the front teeth and she was very happy with the result.
BEFORE AND AFTER SMILE
Changed completely from a manly smile to a feminine smil and patine was very happy with the result.
This case is given in more detail on this link