1-Full Mouth Reconstruction – Crowns

What has been done?

Mr J is a special case. He has been coming to Surbiton Smile Centre to see Dr. Soltani since 2003. Mr J had problems with decay and grinding his teeth. A smoker, his condition was made worse as his saliva secretion was next to nothing. These additional risk factors made Mr J more prone to tooth decay and erosion. To begin to restore his teeth to health, we needed to find out what was going on. Firstly, Mr J went to see hygienist to improve his general oral hygiene.

A saliva test showed that his lack of mouth moisture was a severe problem. We asked him to cut down on his smoking and drinking, and rinse his mouth twice day with fluoride mouthwash. Over a course of a year, this would strengthen the tooth enamel. A blood test at his GP also revealed Mr J had a liver problem. We drew up a personal treatment plan in consultation with Mr J to boost his confidence and improve his social life. His decayed teeth would be restored over several years, a course of action that required considerable co-operation from the patient. He only wanted to restore his upper jaw, so we kept the upper-left canine and with orthodontist treatment brought the upper teeth forward, making plans to increase his bite and the height of the teeth.

We made a personal mouth guard for him to protect his teeth from grinding and allow the teeth to move forward in both his upper and lower jaw. These measures managed to increase Mr J’s bite, giving him an extra 2 mm. Mr J’s new upper teeth were designed on a wax model. To accommodate the longer teeth, we needed to reshape his gum as well. We made him a set of temporary crowns, which he wore for several months to get used to his new bite height. At this stage, we could alter and adjust his crowns until Mr J was happy with his new teeth.

He had regular check-ups on his oral hygiene and we monitored how he was getting along with his new teeth. After 9 months, we took a final impression and built new crowns from metal-fused porcelain. On the lower-right side we placed an implant to provide him with a better chewing platform. With this type of case, treatment continues with a good programme of daily dental hygiene. With a good diet, good saliva flow and cutting down on fizzy acidic drinks, Mr J can expect to keep his new teeth for many years.

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