Getting Her Life Back

A detailed diagnostic evaluation came first. The immediate task was to get her to a place where she could start enjoying her life again: stabilize her infections and take away the pain and discomfort of chewing.

She was very quickly placed in rigid, attractive provisional restorations. Some of the teeth in her upper jaw were hopeless for the long term but not useless: they carried her upper provisionals while new implants were placed to carry provisional teeth in the lower jaw.

Those provisionals let her chew and eat comfortably at once, and start enjoying her life again.

Once the implants had been placed and were healing, she was comfortable, eating, and gaining confidence, and it was time to talk about the next part of her treatment. She had come with many problems, but had not realized what else was affecting her smile: it was extremely gummy. When she smiled, more gum than tooth showed in the upper jaw.

The digital mock-up gave a conservative picture of how much the gummy smile could improve. The final result was better, and less gummy, than the digital plan.

Implant positions were designed in three dimensions. The implants were placed ideally, in a more apical position, higher up, so that the gummy smile disappeared as part of the treatment. Precise, deeper implant placement can create a beautiful smile and eliminate or greatly reduce a gummy smile while fixing every chief complaint: aesthetics, form and function, by planning precisely.

The provisional phase is always the critical phase for judging the desired outcome and deciding what is ideal for a particular patient. It is a team effort between doctor and patient, and sometimes a family member. In her case her daughter joined some of the planning visits to help design the smile her mother deserved. It takes time and cannot be done overnight, but the difference it makes is life-changing.