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This woman’s upper front teeth did not compliment her otherwise attractive appearance. She had several existing dental restorations that had been done over several years, but most of her front teeth had not been restored with crowns.
We did eight All Ceramic Crowns on her upper front teeth to give her teeth a more natural appearance.
Multiple Crowns Before
This pre-op photo of a man in his 60s shows his upper teeth worn almost in half due to a lifetime of heavy chewing and grinding his teeth. His lower teeth had also been worn but Douglas P. Clepper, DMD had already restored his lower teeth with crowns.
Multiple Crowns After Close-up
This is the view after Dr. Clepper restored all the upper teeth with porcelain-to-metal crowns. Several treatment steps were necessary to restore the patients bite to normal so the crowns could be made to the length they should have been if the patient had not worn down his own teeth.
Multiple Crowns After
The patient can now smile with confidence and can function better. A case like this is called a full mouth reconstruction because it is typical that all the teeth in the mouth are restored with crowns to get the desired result. There are many important quality control steps involved in doing a case like this so it is extremely helpful that our own laboratory does all of the laboratory steps.
This patient had an underbite of most of his lower jaw. He wanted his teeth restored as perfect as they could be. In order to do this Dr. Clepper referred the patient to an oral and maxillofacial surgeon. In the hospital under general anesthesia the oral surgeon performed an orthognathic surgical procedure that was essentially a controlled fracture of the jaw to correct the underbite. The patient had his teeth stabilized with wires and/or rubber bands for six weeks.
After the patient was healed from the orthognathic surgery, Dr. Doug Clepper adjusted his teeth until the bite was even, then Dr. Clepper crowned all of his teeth except seven lower front teeth. Three of the crowns in the upper left area of the mouth were supported by dental implants. The crowns on the upper front teeth are all porcelain crowns. The patient was very pleased with the result and he felt that it was worth the inconvenience of the orthognathic surgery healing process.
Fixed Bridge and Partials Before
This is a case Douglas P. Clepper, DMD treated using a combination of a fixed bridge to replace the four missing front teeth and upper and lower removable partial dentures to replace the back teeth. In this pre-op photograph, the four upper front teeth are replaced with a removable partial, and the same upper removable partial replaced the upper back teeth. The lower back teeth are replaced with a lower partial.
Fixed Bridge and Partials After
This post-op photo shows the new fixed bridge replacing the missing upper front teeth, as well as the new upper and lower partials. The upper and lower partials do not show the wires because they are made by a special technique so that the attachment of the partials to the crowned teeth are inside the crowns, so they do not show.
Implant Supported Bar
This is a confusing view to a non-dentist. You are looking at a mirror view of the lower jaw, like you are on the roof of the patients mouth looking down. Shown is a bar screwed in place to five implant abutments. The bar is not removable by the patient but a dentist can remove the bar with a special instrument.
Inside View of Bar Supported Clip-on Teeth
Dr. Douglas P. Clepper has hundreds of cases like this photograph because he has over 20,000 slides or digital photos of various views of implant cases or clinical steps of implant cases. This is a more recent case showing how our laboratory incorporates a metal structure inside the lower overdenture. An overdenture is similar to a regular denture, but one like this is much more retentive because six attachments that are in the gold structure inside the overdenture, allowing for lower teeth to snap on the bar so they do not move during chewing.
Overdenture In Mouth
The overdenture looks like a denture in this lip-retracted view but it functions like natural teeth, since it does not move.
Lips Retracted View
With lip retractors in place, you can see that this patient has a conventional upper denture with the implant supported lower overdenture.
With the natural smile view, the upper denture and lower implant supported overdenture look very natural.
PFM bridge and crowns pre-op
Pre-op photo showing one front tooth replaced by an artificial tooth bonded to adjacent teeth. The other natural front teeth are tetracycline stained with some stained fillings.
PFM bridge and crowns butt margins
The two restorations on the left are porcelain fused-to-metal crowns. The bridge is on the right. The bridge is an artificial tooth supported by two crowns.
PFM on blue paper
PFM bridge and crowns, post-op
Douglas P. Clepper, DMD had previously done some other crowns on the right side of this photo. This is the photo after the bridge and two crowns were placed. It is common for a patient to get one section of their mouth done at a time with crowns.