A Full Mouth Dental Implant Case. The patient is always right!

This week we completed a full mouth upper implant case using a cast bar and denture teeth. This was the case in the laboratory.

On the articulator

One particular issue we has was the size of the teeth; the patient had a fixation on the size of teeth and was concerned that oversized teeth would make the denture stand out and not look natural. However we went ahead and made the fixed implant bridge as requested following the try in of the teeth she asked for.

Dental Implant Bridge Palatal View

Dental Implant Bridge Labial View

Here's the finished result notice the size of the denture teeth!

It's interesting to note the difference between how the bridge looked on the articulator and then in the mouth. On the arictulator the small size of the teeth were not as apparent, but in the mouth, with the reference points of the nose and smile it is immediately clear to us as dental professionals that they are slightly too small.

But the patient is always right? And she loved them, but this could so easily have been a mistake rather than a success.

So, what lessons can we draw from this?

I think the biggest lesson is to use photographs both in the laboratory and in the surgery to communicate and share. On articulators we can easily make a mistake as we don't have the reference points of the nose and smile... but in the mouth, those small mistakes quickly come to light.

So get those photos shared.... how else can we avoid simple mistakes like getting the size of the teeth right?

Dental Implant bars - How to get them right first time...

Choosing the right type of restoration for a large full arch implant reconstruction can be difficult. Many times a denture may be the best option (perhaps to replace lost support for the face) but the patient won't accept as removable appliance! It's a difficult one to manage.

So here are our top tips for ensuring a predictable result:

1. Start, pre implant placement, with a try-in full denture WITH gum work
2. If the patient ideally wants a fixed bridge have another try-in WITHOUT gum work so you can see the emergence of the teeth
3. Use the try-in to decide if there is enough room for a bar or studs, if not enough room discuss options with us.
4. Do not proceed until the patient is happy with the try-in
5. Get us to turn the try-in in to a stent
6. Place the implants using the stent
7. Once integrated get us to make the bar with a 'snap' on bite block and final test set up
8. Once happy go through to completion

The key is the set up at the beginning, don't be tempted to guess or move too fast without getting this right. This is THE absolute KEY to predictability.

To help further with this we are running a study evening, here at the lab (a quick 15 minutes from Kings Cross Station or Jnct 22 on M25) on Tuesday 30th November 6:30pm for 2 hours.

Study Evening - The Edentulous Patient, an evening looking at CADCAM Bars and Frameworks

To book, please call the lab on 01707 663293 or book online here http://www.sbodentallaboratory.co.uk/events.html

We look forward to seeing you.