40 year old, Female

40 year old, Female

• Seeking cosmetic dental treatment for tooth discoloration relating to upper front teeth.
• Trauma from previous fall lead to the need for root canal and crown treatment – dislike dark grey appearance at the gum line.
• Missing teeth in lower jaw – would like to improve eating and chewing abilities.

• Individual tooth analysis from all aspects reviewed issues of
  • Infected endodontic (root canal) treatment with chronic apical periodontitis / periodontal disease (gum and bone infection).
  • External invasive root resorption in upper left central incisor tooth – unrestorable.
• Aesthetic / Cosmetic Challenges
  • Dark tooth discoloration with greying through thin gum and bone from endodontic (root canal) treatment and metal support of preexisting porcelain fused to metal dental crowns (PFM crowns).
  • High lip / smile line with full display of gum support around front teeth – demonstrating different zenith (gum height) from varying extent of recession (gum shrinkage).

• Dismantle and investigation of all preexisting dental crowns to determine the restorability of remaining teeth (saving teeth where possible if prognosis is favourable).
• Temporary dental crowns and upper acrylic partial denture based on smile makeover design with diagnostic wax up – to allow for daily function whilst treatment takes place in stages.
• Collaborative dental treatment with other dental specialists
  • Endodontist – Root canal retreatment and internal tooth whitening / bleaching of upper right lateral and central incisor teeth.
  • Periodontist – Extraction (removal) of upper left central incisor tooth (temporary denture replacement) and dental implant placement.
• Conventional tooth supported dental ceramic crowns on upper right lateral and central incisor teeth and dental implant crown for the replacement of extracted (removed) upper right central incisor tooth.