Beautiful Smiles by Dr. Keerthi Senthil

Case 11

Patient was unable to chew food due to several missing and broken teeth. He wanted to be able to smile again and eat his favorite foods.

Patient received a full arch zirconium fixed prosthesis on his upper arch supported on 8 implants. This material provides unmatched strength and esthetics. On the lower arch he received fixed metal acrylic prosthesis on 4 implants. This prosthesis has a long track record of durability and efficiency.

The nature of the bone in the lower arch permits the placement of minimum of 4 implants to support a full arch prosthesis. While more number of implants are required for the upper arch due to the porous nature of the maxillary(upper) bone.

Case 12

This patient suffered with an ill-fitting upper denture for several years. She lost her upper teeth at a very young age and as a result more than 50% of the supporting bone was lost as well. She desired to get a fixed implant supported prosthesis.

She received bone augmentation procedures to increase the bone dimensions to receive standard diameter implants. Her function and smile was restored with a metal acrylic implant supported prosthesis in the upper arch. The health of the lower teeth and gums were restored with well fitting crowns and appropriate periodontal care. The posterior(back ) missing teeth were replaced with individual implant supported crowns.

Case 13

Patient resorted to dentures after she lost her teeth due to financial reasons. Her main concern was sore gums and loose dentures especially on the lower. She was given all her treatment options and she chose an upper denture and a lower implant supported fixed metal acrylic prosthesis. This is an excellent option for someone who has good bone to support a well fitting upper denture and is limited on funds. An upper denture covers the palate and interferes with taste sensation and may initiate the gag reflex in some patients. The speech impairment with an upper denture is soon overcome.

Patient’s function was restored with an upper well-fitting denture and a lower implant supported fixed metal acrylic prosthesis.

Case 14

Patient presented with decayed upper anterior teeth that could not be saved. Her edge to edge front teeth relation made the case more challenging. Replacing the decayed teeth required opening her vertical dimension with porcelain onlays on her back teeth. This helped to restore the anterior teeth to normal tooth dimensions.

The result is a beautiful smile which the patient always wanted!!!

Visualizing the end result using a diagnostic wax mock-up will help avoid expensive remakes and a comfortable experience for the patient.

Case 15

Patient had undergone extensive periodontal surgery to treat her gum disease and was on maintenance therapy for several years. She maintained excellent oral hygiene but her lower anterior teeth were loose due to extensive bone loss around these teeth. She was uncomfortable biting into foods. She wanted to replace the loose teeth with implants.

She had lost considerable amount of bone around the lower incisor teeth. There was still adequate bone in the area of the canine teeth to place implants. So it was decided to extract the incisors and augment the area with bone graft to ensure good post-treatment gum levels. Implants were placed immediately after extracting the canine teeth.

The mobile lower anterior teeth were replaced with a fixed metal ceramic prosthesis supported on 2 implants.

Look at the regained gum and bone levels around the incisor teeth. Failure to augment this site with bone graft at the time of extraction will cause considerable bone loss and subsequent gum recession.

Case 16

Patient presented with missing lower back teeth and complaint of inability to chew foods.

Due to the lack of molar teeth her anterior teeth showed signs of wear. Patient had a lower metal acrylic partial denture replacing the lower back teeth but she did not wear it as it was uncomfortable. Since she was diabetic she wanted to know if implants were an option for her.

Well- controlled diabetics are good candidates for implants. We treat them based on set guidelines and implant survival in these patients are similar to non-diabetics. Her back teeth were replaced with implants after regaining the lost bone dimensions with bone grafting.

Don’t let your medical condition prevent you from replacing your lost teeth with implants.

Case 17

Patient presented with a long span failing bridge in the lower jaw. With tooth supported bridges the anchor teeth are prone to decay and gum disease. In this case, one of the anchor teeth had extensive decay and could be saved. Another anchor tooth needed root canal treatment and crown coverage. Patient did not want to get another bridge as additional natural teeth will have to be involved.

The decayed tooth was extracted and bone grafting was done to increase the bone dimensions to receive implants. Two implants were placed and restored with individual crowns.

Case 18

Wearing ill-fitting dentures for many years led to an alteration in the normal jaw position. Patient presented with a Class 3 bite relation or what is called reverse bite.

Patient desired implant supported fixed replacement for the lower arch and a conventional denture for the upper arch.

Patient normal jaw relation was re-established by fabricating a well-fitting upper denture and an implant supported metal acrylic fixed prosthesis for the lower arch.

Case 19

Patient presented with a missing tooth in the upper left side and wanted to replace it with an implant supported crown.

There was inadequate bone in height to place an implant. A sinus grafting procedure to increase the height of bone was performed. Sinus grafting is a very predictable procedure with a success rate of greater than 90%. Implants placed in grafted sinus have a survival rate similar to that of implants placed in native bone.

Implant placement was done in conjunction with sinus grafting. This is an option in selective cases and drastically reduces the treatment time.

The missing molar tooth was replaced with a implant supported metal ceramic crown.

Case 20

Patient presented with advanced periodontal disease. Teeth could not be saved. Patient did not want to go without teeth during the healing phase.

So treatment was planned to extract the teeth, place implants and deliver an implant supported transitional prosthesis on the same day of surgery.

A stereolithographic bone model guided surgery was planned and duplicated in the mouth.

Final prosthesis was a upper conventional denture and a lower implant supported fixed metal acrylic prosthesis.

To know more about this call our office and make an appointment.

Case 21

Patient presented with extreme bone loss involving the basal bone of the mandible. Patient was having sensation of numbness due to dehiscence of the mental nerve.

With the help of model guided surgery 4 implants were placed precisely without harming the mental nerve.

Patient’s function and smile was restored with an implant supported fixed metal acrylic prosthesis. Because the prosthesis was completely implant supported pressure on the mental nerve was relieved and numb sensation disappeared .

Case 22

A young patient presented with ill-fitting dentures that gave her an old age look. The corners of her mouth were droopy and the youthfulness of her smile was lost.

Her smile and vigor were restored with implant supported fixed prosthesis.

Case 23

A 72 year old patient has never looked back after he had his first missing tooth replaced with an implant. As and when his teeth were no longer serviceable he did not think twice to replace them with implants. He understands how implants works and knows that they are the best replacement for a missing tooth.

His upper teeth were replaced with implant supported metal ceramic crowns.

Case 24

Patient presented with advanced stage periodontal disease. His smoking habit made things worse and his teeth could not be saved.

His upper and lower teeth were replaced with implants after sinus grafting and bone augmentation procedures.

Patient’s smile and confidence restored with upper and lower implant supported fixed metal acrylic prosthesis.

Case 25

Patient presented with Advanced stage periodontitis which was under remission. Patient was under maintenance care for over 2 years. Although the disease was under control patient was unhappy with her smile.

Treatment involved a combination of tooth and implant supported crowns.

To know more about how we can help you call our office to find out!

Case 26

Patient presented with an old implant retained fixed denture. The denture was unsightly and the patient was very unhappy with the work of the previous dentist. After careful evaluation of the case Dr. Senthil changed the implant angulation with custom abutments and fabricated the fixed denture using zirconia.

Zirconia is a strong durable and beautiful material which does not stain.

If you will like to know more about this material ask your dentist.

Case 27

Patient had aggressive gum disease which led to extensive bone loss. The front teeth had little to no bone support. The teeth were held in place with orthodontic wires.

Front teeth were removed, implants were placed and simultaneous bone grafting was done. The anterior teeth were replaced with a fixed implant bridge.

Imagine being able to bite into an apple again!!!!!

If you have been putting off dental implants thinking that you might not be a candidate think again.

Case 28

Patient had aggressive periodontal disease which led to their loss. Patient had severe gum infections and extensive bone loss.

Dr. Senthil was able to place four implants and perform simultaneous bone grafting. The All-on 4 implant procedure is a patented procedure for patients who have limited bone. With this technique we can replace all teeth in one jaw with 4 implants.

If you will like to know if you are a candidate for this procedure call our office for a consultation.

Case 29

Patient presented with several missing teeth and extensive wear of the remaining teeth. He was unable to chew food. He wanted a permanent solution and an improved smile.

Using 3D bone model we planned to remove all his remaining teeth and place implants at the same time.

The entire mouth was treated in one session under general anesthesia.

We love to see our patients smile without concealing it!!

We thank our patients for allowing us to treat them which gives us immense job satisfaction.

Case 30

Patient lost his lower right canine tooth in an accident with accompanying loss of bone and gum tissue. Neighboring natural teeth were virgin teeth and hence tooth supported bridge was not an option.

The lost supporting bone and gum tissue were regained with bone and tissue grafting. Implant was placed and restored with a metal ceramic crown to match the neighboring teeth closely in color and surface details.