Full mouth reconstruction to restore esthetics and function

Treatment Goals: Restore proper vertical dimension of occlusion, restore proper canine guidance, establish proper gingival contours and tissue harmony, establish a stable occlusion and improved esthetics.

Prior to treatment, an occlusal splint was used to reestablish a comfortable jaw position and occlusal relationship. A diagnostic wax up was used to fabricate a guide to aid in the laser gum surgery. Gingival heights were based on esthetics and level of attachement.  The wax-up as well as the unglazed bisque crowns were tried in to verify an accepted esthetic result. The final outcome took approximately 4 months to complete. Because of limited finances, the patient chose to complete the upper and lower 10 front crowns now and the back crowns at a later time. Temporary occlusal composites were used to stabilize the back teeth until further treatment.

Before2 Before Diagnostic-wax-up gum-surgery gum-surgery2  temporary-crown temporary-crown2 upper-provisionals Wax-try-in Lab1 lab2 lab3 lab4 Upper-bisque-tryin Final-smile final-smile2 final-smile3 final4

Party gums

Here is a cost effective way to treat a patient who had a history of periodontal disease followed by subsequent bone loss and recession.  This patient’s current periodontal condition is now controlled.  Pocketing depths are 2-3mm, tissue levels are stable and routine periodontal cleanings every 4-6months.

Treatment: We fabricated a removable cold cure acrylic resin prosthesis from a  mock wax-up on a solid cast.  The cast was carefully surveyed and blocked out to allow a path of insertion while still maintaining some retentive undercuts.

Advantages: Cost effective, predictable long term result, non-surgical alternative.

Before Labwork final

Anterior Veneer Case




This patient presented with discolored composite veneers on #7-9.  She was unhappy with the esthetics and wanted to improve her smile with a better type of restoration.  There was a pre-existing diastema between #8-9 and midline discrepancy.  Upper and lower teeth met edge to edge with only a slight horizontal discrepancy.  Gingival harmony was within normal limits.

Treatment plan: We decided to whiten her teeth prior to replacing #7-9 with conservative porcelain veneers.

Before Preps