Case Study – Full Mouth & Smile Rehabilitation with Orthodontics, Implants

Initial Situation

This patient presented to Contemporary Smiles with the following complaints:

  1. Unhappy with the look of the ceramic veneers that were placed elsewhere some years prior
  2. Lack of a back bite due to loss of some of her molars leading to decreased chewing capacity and comfort
  3. Chronic pain and discomfort in the temporomandibular joint due to a 100% overbite and lack of any back teeth touching
  4. Recurrent decay and poorly contoured teeth around heavily restored back upper teeth
  5. Significant resorption of bone where teeth had been lost in the back of the mouth.

The Treatment Plan

After careful consultation, Dr Barry Phelan, outlined in detail the challenges that needed to be overcome to correct the issues and give the patient a natural smile and functional, pain free bite.


Sequence of treatment

  1. Treatment of decay and any periodontal issues
  2. Orthodontics to correct the overbite and correct retroclination of the remaining teeth on the lower arch (Dr Guy Farland, Smileteam)
  3. Placement of a combination of crowns or veneers on remaining upper teeth and a new crown on the an old implant in the upper right lateral incisor (Master Ceramist, Rob Dulieu,
  4. Placement of an implant in the lower right to support a crown and a porcelain crown on the lower left back tooth to allow for good bite contact with their opposing teeth. Provision of a stable back bite utilising a shortened dental arch concept due to difficulty in placing any further implants due to lack of bone
  5. Provision of an occlusal mouthguard to be worn while sleeping
  6. Regular appointments with our therapist to maintain the health of the periodontal tissues.

The Outcome

he patient was happy with the final outcome. She smiles with confidence, can chew easily and no longer has pain in her joint.