Hello,
drmikemaroon has just posted in the Prosthodontics & Dentures forum of ACE Dental World under the title of Nice Mixed Case: Immediate Full Upper Denture over eMax and Implants!.
This thread is located at http://www.acedentalforum.com/forum/threads/2616-Nice-Mixed-Case-Immediate-Full-Upper-Denture-over-eMax-and-Implants!
Here is the message that has just been posted:
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Here's a nice mixed case that is currently being treated in my office. This woman is the sister of another Dentist, who brought her to me for rehabilitation.
This woman is in her 50s and had several PFMs, an existing upper partial denture and several hopeless/broken teeth throughout her mouth. After consulting with both the pt and her sister, it was determined to extract all remaining upper teeth and make an immediate full upper denture. On the lower arch, we would save what could be saved with eMax restorations and extract the broken down teeth and place implants where there were none.
Before photos:
Attachment 5450 (http://www.acedentalforum.com/forum/attachment.php?attachmentid=5450)Attachment 5451 (http://www.acedentalforum.com/forum/attachment.php?attachmentid=5451)Attachment 5452 (http://www.acedentalforum.com/forum/attachment.php?attachmentid=5452)Attachment 5453 (http://www.acedentalforum.com/forum/attachment.php?attachmentid=5453)Attachment 5454 (http://www.acedentalforum.com/forum/attachment.php?attachmentid=5454)Attachment 5455 (http://www.acedentalforum.com/forum/attachment.php?attachmentid=5455)Attachment 5456 (http://www.acedentalforum.com/forum/attachment.php?attachmentid=5456)
Usually when I do a full mouth restoration, I ask the pt to bring in a photo of a smile that they like, or photos of themselves when they were younger. She happened to have a couple of photos of her original smile that I thought we could restore to.
Attachment 5457 (http://www.acedentalforum.com/forum/attachment.php?attachmentid=5457)Attachment 5458 (http://www.acedentalforum.com/forum/attachment.php?attachmentid=5458)
First step was to get a diagnostic wax-up from Gold Dust Dental Lab. They waxed up both upper & lower arches to ideal based on my bite registration. After getting the wax-up, I took an impression of the pts upper arch and sent that, along with models of the wax-up and bite to James Dean Prosthetic Lab to have the upper immediate denture made. James Davidge, of James Dean Dental Arts is a wizard with dentures. He nailed the smile that the pt wanted with his immediate denture set-up.
When the immediate denture came back, I extracted all of the upper teeth, and lower right teeth, and prepped all of the lower teeth that same day. Here are a couple of photos of the preps and prep shade that I sent to Gold Dust to have the new restorations made. Here are photos of the immediate denture in place and the prepped teeth.
Attachment 5459 (http://www.acedentalforum.com/forum/attachment.php?attachmentid=5459)Attachment 5460 (http://www.acedentalforum.com/forum/attachment.php?attachmentid=5460)
The pt was placed in a Luxatemp lower provisional that was made from the diagnostic wax-up from Gold Dust Dental Lab. She wore that for 4 weeks.
Attachment 5461 (http://www.acedentalforum.com/forum/attachment.php?attachmentid=5461)
Pete & Paul from Gold Dust Dental Lab really did a great job on making the lower teeth esthetically pleasing. When the case came back, I seated the lower restorations and placed Astra Tech implant fixtures on the lower right. Here are some photos of the case where she is today with the upper denture opposing the restored lower natural teeth and waiting on the implants to integrate.
Attachment 5462 (http://www.acedentalforum.com/forum/attachment.php?attachmentid=5462)Attachment 5463 (http://www.acedentalforum.com/forum/attachment.php?attachmentid=5463)Attachment 5464 (http://www.acedentalforum.com/forum/attachment.php?attachmentid=5464)Attachment 5465 (http://www.acedentalforum.com/forum/attachment.php?attachmentid=5465)Attachment 5466 (http://www.acedentalforum.com/forum/attachment.php?attachmentid=5466)Attachment 5467 (http://www.acedentalforum.com/forum/attachment.php?attachmentid=5467)Attachment 5468 (http://www.acedentalforum.com/forum/attachment.php?attachmentid=5468)Attachment 5469 (http://www.acedentalforum.com/forum/attachment.php?attachmentid=5469)
Here are before & after full face photos for comparison:
Attachment 5450 (http://www.acedentalforum.com/forum/attachment.php?attachmentid=5450)
Attachment 5470 (http://www.acedentalforum.com/forum/attachment.php?attachmentid=5470)
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