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Case Studies

Periodontal (gum) plastic surgery case

This 23 year old young woman presented at our clinic  for a normal routine check up. She also complained of a somewhat gummy smile and short front teeth.  She agreed to undertake further investigations such as a CBCT scan and bone sounding to determine the level of the bone holding  her teeth in the jaw.  The results showed that she had excess bone surrounding  her teeth necks which caused the appearance of overgrown gums and short crowns.

A surgical operation was undertaken after thorough planning and the exact right amount of bone was removed to achieve  a longer permanent length to the incisor crowns. Excess bone was removed from the premolars and first molars as well due to short clinical crown height.

A six month wait was necessary so that the gum level permanently stabilizes before all ceramic crowns were constructed in the lab.

The decision to crown the incisors was reached due to the fact that they were somewhat worn and eroded.  Some small tooth coloured (composite) fillings were also done to remove small areas of demineralization which developed with time.

During the 6 month wait the other teeth were whitened using a Zoom take home bleaching kit and trays. This was done at home by the patient and delivered superb results.

The final result is simply amazing  and a very happy patient.

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Complete oral rehabilitation case

This 24 year old woman presented to us with constant pain from all back teeth.  Since she was pregnant at the time, the pain was causing her significant distress. On examination we found a state of general neglect with decay in most of her molar/premolar teeth. Emergency extractions were planned and executed to relieve her of pain, and a good scaling/polish with oral hygiene instructions was done.  X-rays had to be postponed for after pregnancy.

A few months after the pregnancy she returned with the intent of restoring her smile and function.  A proper examination was done and x-rays were taken.  We determined the treatment which had to be done on each tooth and any remaining extractions were done.

A four month waiting period after extractions was advised during which any remaining fillings were done  and  a tooth whitening  treatment was prescribed  for the lower teeth. After the four month period passed, the upper front teeth were restored with four all ceramic crowns. All missing back teeth were replaced with four porcelain fused to metal bridges while the lower six front teeth were whitened and restored with tooth colored composite filling material.  Patient was extremely satisfied with her new looks and new found function.  Case is still in function after thirteen years.


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Denture stabilization case

This 67 year old woman presented at your clinic desiring a more comfortable solution instead of her poorly fitting old full upper and lower dentures. After a consultation we decided to go for a new full upper denture and full lower denture stabilization using mini implants. Mini implants provide a cost effective method of stabilizing dentures when done properly.

Using our cone beam scanner and Simplant software we could again place the mini implants in the correct position in the bone providing peace of mind both for the dentist and the patient. Pain and discomfort during and after this procedure is minimal with a similar intensity and type as that experienced after  dental extractions. After 1.5 months of the surgical intervention her new dentures were fitted. She reported an immediate  improvement in her eating and chewing habits.  She now attends for 6 monthly check ups for cleanings and evaluation of gum health around her implants.

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Implant retained denture

This 62 year old man attended our clinic complaining of pain and mobile upper bridge. On examination we found that he was suffering from chronic periodontal disease and a failed fixed restoration with decay.

A complete extraction of all remaining upper teeth was the only solution. We decided to opt for an implant retained denture since quite a lot of facial support from the denture was needed. After preparing our study using Simplant and our cone beam scanner,  4 Straumann implants were placed in a completely painless procedure.  After 1-2 months of healing his new denture was constructed and delivered, resulting in completely enhanced  facial features.


Implant reconstruction case

This 49 year old lady presented in our clinic with recurrent discomfort coming from the upper jaw. On examination including  x-rays we discovered that she had chronic periodontal disease which was especially advanced in the upper jaw. Many teeth were mobile.

After a lot of discussions we decided that the upper teeth could not be saved and had to be extracted. Actually this was quite a shock for the patient and she decided that a fixed restoration would be the only outcome that she could accept. A temporary full acrylic denture was constructed and fitted after the extractions of the upper teeth. The lower teeth were cleaned and curetted by our hygienist and an oral hygiene instruction was given to the patient so that she could save her lower teeth of which her front teeth were already slightly mobile. A fiber reinforced composite splint was fitted to stabilize the lower anterior teeth.

After a wait of 3 months a cone beam tomograph was taken and implants were placed in the ideal position on the virtual jaw using Simplant software.

A surgical guide was ordered and implants were placed without raising the gums (flapless). As a result she experienced very minimal discomfort after surgery.

A temporary bridge was placed immediately which was replaced after 3 months with the definitive full upper bridge. After 5 years of function we still have an extremely happy patient attending regular 6 monthly check-ups and keeping an impeccable daily cleaning schedule!






Functional and Aesthetic rehabilitation

This young man was 24 years old when he presented with a poorly fitting upper bridge. He was complaining of bad breath and taste combined with jaw joint discomfort.

On examination we found that the full upper bridge had a very poor fit with lots of plaque/food accumulation. The bite was also not ideal which most probably was causing his jaw pain. He also needed a general cleaning and oral hygiene instructions due to poor brushing habits.

In due course the upper bridge was removed and replaced with proper porcelain/metal crown and bridge work. The patient reported an immediate improvement of his bite, aesthetics and jaw pains. He was also relieved that with our intervention his bad breath was eliminated. 








Aesthetic & functional rehabilitation

A 48 year old woman presented in our clinic complaining of a general discomfort in her mouth, bad breath and mobile teeth. On examination we found that she was suffering from an advanced stage of chronic periodontal (gum) disease. After several examination appointments we determined and classified all teeth in groups:

  • Those which are healthy and need no treatment
  • Those which can be saved by treatment
  • Those others which are hopeless and need to be removed

Several appointments were scheduled with the dental hygienist and dentist where the teeth were cleaned and gum disease treated and monitored. Hopeless teeth were removed. Two provisional partial dentures made of acrylic (upper and lower) were constructed and fitted. Our patient now has to decide if to continue treatment and pursue a  fixed teeth alternative while still monitored by our hygienist to keep her gum diseases under control!


Removable Acrylic Denture

This 53 year old women presented with an ill fitting old partial acrylic denture, which was not aesthetically pleasing  also due to the marked midline shift of her upper incisor.

After examination and  a long discussion with her, we decided to construct on immediate upper partial denture. After a routine cleaning and oral hygiene instruction,  we took preliminary impressions and the denture was constructed in the lab. As soon as the denture was ready we extracted her remaining two front teeth which were also affected by gum disease. The new removable denture was fitted and provided a new beautiful smile to our patient.  This kind of treatment is a low cost option which delivers very pleasing outcomes.

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Complete Oral rehabilitation Case 2

This 48 year old woman presented with a deteriorating oral condition including  failing restorations, bad breath, chronic periodontal disease, decay and a general reluctance to smile and socialize.

After a thorough examination we came up with a treatment plan which included scaling, polishing and curettage to remove the tartar deposits, fillings and  extractions. The definite restorations were constructed after a take home zoom whitening course. The upper teeth were fitted with all ceramic crowns and bridge work, while the lower anterior teeth were splinted with a fiber reinforced composite splint.

She is currently under review due to check if her gum disease is under control.

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Aesthetic rehabilitation with immediate full dentures

This 55 year old lady presented to us with a failed dentition and a dysfunctional old partial acrylic denture. Due to financial restrictions she wanted a removable solution with the option of getting a fixed implant retained bridge or the denture stabilized with implants in the future. The remaining teeth were deemed to be not salvageable.

Impressions were taken and following a set of appointments, full upper and lower immediate acrylic dentures were constructed. All the remaining teeth were extracted and the dentures were fitted on the same day. She was ecstatic with her new look since she never thought that such a beautiful aesthetic result was possible in her case. The denture was relined periodically with a soft lining material. A definite acrylic reline was done after 6 months where she reported highly improved masticatory performance and aesthetic confidence. She still has the fixed implant solution on her mind. In case she decides to continue with the treatment we now have the aesthetic and functional foundations ready.

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