Serving all of Central and Western Montana ~ Located in Missoula

Case Study 8: Implant Prosthesis

  • This patient presents in his mid 70s with a substantial amount of previous crown and bridgework which is now failing.  The restorations demonstrate multiple porcelain fractures, underlying decay, mobility, as well as several root canal abscesses.

    Joe Meng, DDS, MS

  • Esthetic evaluation demonstrates mismatched tooth color between upper and lower teeth, as well as an imbalanced smile plane, and poor tooth size proportions.

    Joe Meng, DDS, MS

  • After close examination, the degradation of the upper arch was determined to be too severe to be salvaged without heroics, due to the extensiveness of dental disease and abscesses.

    Joe Meng, DDS, MS

  • On the lower jaw, the right bridge (left side of screen) will be lost due to abscesses and periodontal disease, the crowns on the opposite side have structurally failed down to the metal substructure.  Decay is also present on several of the front teeth.

    Joe Meng, DDS, MS

  • After discussion with the patient about the diagnosed problems and possible treatment options, a final treatment plan was formulated.
    The most reasonable treatment plan for this patient given the gamut of his problems, was extraction of all upper teeth and the lower right bridge.  Definitive prosthetic replacement for the upper jaw was planned for placement of 4 dental implants to support a removable implant prosthesis.  For the lower jaw, new crowns were to be made on the lower left, front teeth to be conservatively restored with tooth colored composite resin veneers, and the right segment would receive 2 implants to support a bridge.

    Because healing is required after tooth extraction and implant placement, the patient did wear an immediate denture on the upper jaw for an interim period of four month period before the final implant prosthesis could be made.

    This treatment plan involves fixed and removable prosthodontics, in combination with dental implants.

    Joe Meng, DDS, MS

  • This photo of the upper jaw shows the four implant attachments used to help support and retain the patient’s removable implant prosthesis.  

    Joe Meng, DDS, MS

  • This is a photo of the removable implant prosthesis in place on the upper jaw.   When 4-6 implants are used, the palate portion (roof of the mouth) can be left open to allow the patient more tasting sensation when they eat.

    Joe Meng, DDS, MS

  • Then on the lower jaw, 4 new crowns were provided on the patient's left (right side of screen), the 6 front teeth where bonded to proper form with composite resin, and the patient's right side received a 3-unit bridge held by 2 implants.

    Joe Meng, DDS, MS

  • Front view of final restorations.

    Joe Meng, DDS, MS

  • Final smiling photo of final restorations.  Tooth display, proportions, and the bite plane are now much more balanced.

    Joe Meng, DDS, MS
     

  • Before and after frontal view.  Tooth display, proportions, and the bite plane are now much more balanced- providing the patient with better esthetics and function.

    Joe Meng, DDS, MS

  • Pre and post treatment radiographs.  The post treatment radiograph demonstrates the final restorations and dental implants in place.

    Joe Meng, DDS, MS
     

  • Full face photo of the patient with the final restorations in place, and a happy patient!

    Joe Meng, DDS, MS
     

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