Case Study – Full mouth rehabilitation with Implant supported bridges and veneers

Initial Situation

This patient presented quite distressed, unhappy with her smile and had also lost the ability to chew food.

Her upper left canine and first molar were recently extracted after the failure of a bridge that they were holding.

Her lower right first molar and first premolar required extraction also due to recurrent infection and failure of the structural integrity of the overlying bridge.

Both bridges were in some part lost due to the para-functional bite forces that were applied to the teeth by habitual grinding (bruxism) that was left un-diagnosed and treated.

The lower right first molar was also missing.

Wear, cracking and dis-colouration of her front teeth was also present due to chronic bruxism.

Objectives

  • Restore bite functionality
  • Improve aesthetics.

The Treatment Plan

After thorough radiographic, cone beam Ct examination, a detailed occlusal analysis and extensive photographic recording, Dr Barry Phelan presented a number of treatment options which were itemised. The patient accepted the following treatment plan:

Placement of 2 implants with bone graft in the upper left to support a 3 unit bridge

Placement of 2 implants on the lower right and one on the lower left to support a 3 unit bridge and crown respectively

Placement of 4 emax veneers on the incisors to improve colour and strengthen teeth

Provision of a occlusal mouthguard to protect teeth at night and detailed discussion of ways to prevent grinding during the day

This patient wanted to leave the existing bridge on the top right. Replacement would have resulted in a better aesthetic outcome but this was not deemed important enough to warrant further implant therapy.

The Outcome

The patient was happy with the outcome. She did not wish to wear a partial denture and with this in mind extensive implant therapy was carried out by Dr Barry Phelan, who took the case right through from start to finish on location at the practice in Corrimal. The need to control the bite force and the requirement of excellent oral hygiene around the implants was stressed to the patient. Patient compliance is excellent and therefore we are confident that these restorations have the ability to be lifelong.