Mr V came to Elmsleigh House Dental Clinic because he wanted to finalise the look of his smile following orthodontic treatment with Specialist orthodontist, Kostas Spathoulas, and to have a comfortable mouth, teeth and gums.
Mr V saw Cathleen Perrin for an hour-long, comprehensive new patient examination. Cathleen listened to his concerns and performed a thorough dental examination, including necessary x-ray pictures. She discussed that his teeth had some staining and tartar (scale) build-up that needed to be removed. There was a cavity and a worn filling that needed to be restored, and his old silver amalgam fillings needed refurbishing with high-quality tooth-coloured fillings. The x-rays revealed a poor long-term prognosis for his crowned premolar tooth and adjacent molar, requiring proactive intervention. Cathleen formulated a treatment plan to restore Mr V’s teeth using an ABC approach: align, brighten and contour.
The first step was for Mr V to see a hygienist to remove staining and improve his gum health. He continued to see Kostas for his Invisalign treatment, using a series of clear, removable aligners and SmartForce attachments to predictably move his teeth into position. Once his teeth had been straightened, and fitting in with the subsequent treatment plan, a fixed retainer was placed behind Mr V’s teeth as well as removable retainers to wear at night to hold them in position.
To deal with Mr V’s premolar and adjacent molar with a poor prognosis, he saw Kit Spears, one of the dental implant team, to first extract these teeth and then plan to replace with two secure titanium dental implants and implant-retained crowns.
To allow time for the extraction sites to heal, Mr V saw Cathleen to prioritise replacing a worn silver amalgam filling and a small cavity on the adjacent tooth with high-quality tooth-coloured composite material.
His teeth were then whitened to a brighter, natural colour. First whitening trays were made to fit Mr V’s teeth precisely. He was shown how to apply whitening gel to the trays and fit them in place. He took home the trays and sufficient whitening gel to wear the trays for 2–3 hours a day (or overnight) until he achieved the brighter shade desired.
Cathleen then refurbished the old silver amalgam fillings with composite material to match his brightened teeth. She placed some protective bonded fillings on several teeth worn at the gum line (to improve their appearance as well as protect from further wear), and some cosmetic bonding to finalise the contours and symmetry of Mr V’s smile.
Mr V returned to see Kit after 12 weeks for an assessment of the two extraction sites. As these had healed well, Kit was able to place two dental implants under local anaesthesia. A dental implant is essentially a ‘bionic root’, where a small titanium screw is placed into the jawbone, which integrates in a process called osseointegration and actively prevents bone loss. This is buried under the gum and allowed to heal for several months.
Kit then uncovered and tested the implants then placed a healing cap, which protrudes through the gum. Cathleen took impressions and two crowns were made to match the colour of Mr V’s whitened teeth as well as their translucency and shape. The implant crowns were temporarily fitted to ensure he was happy with their function and appearance. As Mr V was delighted, they were definitively secured in place.
Mr V continues to see Cathleen for regular dental check-ups and maintenance, as well as seeing the dental hygienist regularly.
