Appointment 1

With Macca being a confident, charming radio personality we wanted to create a smile that reflected this, and one that Macca would be proud of.

To help rebuild Macca’s trust and faith in the dental profession, we started with a relaxed consultation and x-rays to assess what we could offer. After presenting a number of different options, Macca then made the choice of the treatment he wanted us to carry out on him.

Appointment 2

As Macca requires numerous appointments to restore his smile, we decided to start with simple procedures to get Macca comfortable with being in the dental chair again. On his first appointment, we decided to do two fillings on Macca’s back teeth to help strengthen them and remove the decayed areas. As Macca will testify, this was a pain-free appointment and he was very surprised at how much dentistry had changed since he last visited a dentist.

Appointment 3

With Macca getting used to the dental setting again, we removed three badly decayed teeth that could not be saved. Again Macca, who almost cancelled this appointment, was laughing at how simple and pain-free it was.

Appointment 4

At this appointment with Macca we started the first stage of root canal treatment on his cracked and broken front tooth. This is in preparation of restoring this tooth with a crown to make it aesthetic and sound.

Appointment 5

This was Macca's second root canal appointment. Today we cleaned out the infection and prepared the tooth for the root canal filling. Macca has no problem having his dental treatment now and is no longer anxious at the thought of having a local anaesthetic. He even tries to take a nap in the chair!

Appointment 6

Today we completed two more fillings on Macca's back teeth and also extracted a decayed and broken tooth that could not be saved. We took impressions for Macca's new plastic partial denture. This denture - a temporary measure while we wait for healing to take place in his mouth due to the extractions, will help with his eating along with improving the cosmetics of his smile. Once the gums have healed completely, in approximately 2 months time, then a new partial denture will be made for him.

Appointment 7

Today we finished the third and final stage of root canal treatment on Macca's broken front tooth. As there was no tooth to attach a filling onto, the root canal has allowed us to place a post down into the canal so that the tooth can retain the future crown. We have for now, built up Macca's front tooth in a white filling material to match his other existing front tooth, so now Macca can smile!

Appointment 8

Today we completed all of Macca's fillings by removing the decay and building up two of Macca's back teeth. Macca's mouth is now a "decay free" zone and he is very happy about that as there is no chance of him getting toothache on his trip through the States!!
 
We also tried in the waxed up model of his new temporary denture and checked to make sure his bite was correct. At his next appointment we should be ready to insert Macca's new temporary denture.

Appointment 9

At this appointment we inserted Macca's temporary plate before he leaves for his trip to the USA. Unfortunately Macca was unable to wear the plate, as the plastic over his palate made him feel nauseous. This is quite common and is a major reason why we have to use a fixed plate/bridge or a metal denture in some cases. As we will be making Macca a new metal plate, the problem he has with the plastic will be overcome. With a metal plate we don’t have to make the plate as thick and there is minimal coverage on the palate making it more comfortable. The most comfortable option Macca has available to him is to have dental implants placed with a fixed plate/bridge, as there is NO palatal coverage with this option.

Appointment 10

Macca has returned from his holiday so we are going to start the final treatment needed to restore his smile and fill the gaps between his remaining teeth. We are starting by crowning (capping) his remaining upper teeth to help give them strength and to secure our upper metal plate.

As you can see in this photo, after we removed the decay the majority of the tooth has had to be filled.

Large fillings can cause the remaining tooth to crack and fracture after time so it is usually advisable to crown these teeth. A crown adds protection to the remaining tooth and prevents the tooth from crumbling.

In this photo you can see the preparation done to the tooth for the new crown.

The outer surface layers are trimmed back to the core of the tooth. The crown then sits over the top of the preparation.

An impression or mold is taken of the tooth and sent to a dental laboratory for the fabrication of the crown in porcelain, metal, or gold. We make a temporary crown in white resin to sit over the tooth while we wait for the crown to be made (which usually takes 2 weeks).

Appointment 11

At this appointment we had to prepare the three remaining front teeth for the new crowns. Again the outside surfaces of the tooth are trimmed back to a core material.

We then take an impression/mold of the teeth for the lab to use when they make the porcelain and metal crowns.

To protect the tooth and the preparations we have done, we make temporary crowns i.e the white resin in the photo.

Now that all the teeth have been prepared, we have to design the crowns and metal denture to fit Macca's mouth. As we want to avoid unsightly clasps in the front of Macca's mouth when he smiles, we have come up with two designs to avoid this. The first design involves precision attachments to allow the plate to click into the crowns, while the second uses grooves in the crowns which the plate engages into.

As we want the best result for Macca, we are going to go ahead with the precision attachment. This will secure the plate in position and give Macca the confidence to eat and talk in public without the embarrassment of his plate falling out.

Appointment 12

After two weeks the lab work has arrived. The new porcelain and metal crowns with their precision attachments, are tried in the mouth to check their fit and aesthetics. As you can see in the photos, the metal framework extends from the crowns and this helps to keep the new denture in place. We have also gone with crowns that look really natural. We have not made them look perfect as we want Macca to have a natural looking smile so no-one knows he has had a makeover.
 
After the fit was checked and Macca was happy with the look and colour of the new crowns, we had to take another impression/mold so the denture could be made to fit around the new crowns.
 
We then recemented the temporary crowns and sent all the work back to the lab.

Appointment 13

To ensure we maintain the way Macca is used to biting and chewing, we needed to take a bite registration in wax. So all the new crowns were placed on the teeth and Macca was asked to bite together as he usually does. This registration was then sent back to the lab so they could set the denture teeth in the correct position to correspond with his lower teeth.

Appointment 14

With all the lab work back and the new denture made, we are now ready to cement the crowns into their final position and place the completed denture in place.

We first checked to ensure the denture fitted well and was well adapted to the gums. We then checked with Macca to ensure he was happy with the "look" of his new teeth. As Macca was thrilled with his new look, we cemented the crowns into place and clicked the denture into position. After a few minor adjustment to obtain a correct bite, Macca was all done and ready to show off his new grin.

We would like to thank Dental Studio Mission for all their lab work and advice making this case possible.