The following pictures are all before and after cases prepared and completed entirely by Dr Adam Glassford and his ceramic technician. No photo re-touching or digital enhancement has been used whatsoever
The before pictures here show a slightly crowded upper jaw and missing adult canine teeth. The upper right central incisor tooth was fractured and needed to be removed and an implant placed
The after pictures here show how the misshapen teeth have been transformed with natural looking crowns and veneers. The upper right central incisor was replaced with a single tooth implant, zirconia abutment and matching cosmetic crown. Important points to note here are the zeniths of the central incisor teeth which match each other perfectly. This can be very hard to achieve when a natural tooth is next to an implant. The shade and characteristics chosen reflect a natural look and the patient was particularly keen to avoid a false or overly white result.
This missing single lateral incisor was replaced with a dental implant and restored with a zirconia cad cam abutment and single cosmetic ceramic crown. Natural shades and characteristics were incorporated into the crown to blend with the untouched adjacent teeth. If you look closely you can see many gradations of shade within even just a single crown. Natural teeth have these features so we strive to copy them in our cosmetic restorations. Particular attention was paid to replicating the natural height and contour of the gum. If not done properly, gum levels can rise on implants and fail to match the adjacent teeth. I always aim to place the gum level at the correct height where possible.
This case shows a failing set of natural upper teeth replaced with an immediate implant bridge. The second picture shows the immediate provisional bridge in place whilst the implants healed with the bone. After this was fitted onto an initial 4 implants, 6 further implant fixtures were placed to support upper back teeth implants.
The final upper jaw had 10 implants in place, 4 at the front and 3 either side at the back. This number was necessary as additional sinus grafting was necessary and ideally one implant per toot is used at the back of the mouth in such cases. The total treatment time was around 9 months and again it was the sinus grafting that dictated the timescale. Again in this case, as the patient was in her late 60's she wanted a very natural look to the teeth and requested features that were sympathetic to her age. All of the upper teeth shown in the above picture were created from ceramic and fitted to the implants. The lower teeth are the patient's own.
The starting point here is an old partial denture that had been worn for many years and some old crowns on the upper front teeth. The patient decided that she would like a permanent fixed replacement of the denture and a fresher younger look to the rest of the smile
The case was planned using models of the teeth and numerous photographs looking in particular at the smile line and shape of the lips at rest and at smile. Once the implants had been placed upper right and upper left, the trial smile was fitted over the top as shown above. This allows the patient time to get used to the new shape and contours of the teeth before the final work is created. The trial smile can be altered as many times as the patient wishes until they are happy with the final look. The customised trial smile is then translated into the final ceramic work
The final result reflects the patient's wish list for a healthy fresher look that still looked natural and not out of place given her age.
The starting point here is a bridge supported on failing natural teeth. You can see the dark red abscess above the upper incisor teeth that has resulted from the failing support teeth
Because infection was present, the teeth supporting the bridge had to be removed and initially a temporary denture fitted as seen above. This was in place for a couple of months before the gums had settled enough to allow 2 dental implants to be placed.
2 substantial implants were placed and used to support this 5 tooth implant bridge. The bridge is permanently fixed in place over the silver coloured titanium abutments. Initially the gums 'blanch' from the local anaesthetic as seen above but this goes after a few hours and returns to a normal natural pink colour. Here again the patient was happy with the shade of her natural teeth so we blended the colour and texture in to match
The starting point here was a set of failing upper natural teeth that had become loose over the years. The patient wore an ill fitting partial upper denture so was accustomed to the feel of a denture in her mouth. Implant over dentures work best in patients that have some experience of wearing even a small plate initially.
After removing all the failing upper teeth and fitting an immediate temporary full denture the mouth was left to heal for 3 months. After this time 4 implants were placed in the upper jaw and these can be seen as the gold coloured studs which are in fact a press-stud like fitting on each implant which connects precisely into the black cup seen on the second picture. This creates a very firm clip which retained the implant over denture. The over denture still needs removing several times each day for cleaning especially after meals but is firm when speaking and chewing
The final result shows the lower teeth cleaned by the hygienist and whitened and the upper implant over denture in place. The shape and colour of the teeth is chosen with the patient and here again we have aimed for a nice natural healthy look within the normal light shade range