Holistic Dentistry

DR JEAN PAUL DEMAJO TALKS ABOUT THE MANY FACTORS THAT GO INTO ACHIEVING THE PERFECT SMILE

When treating complicated cases a holistic approach is necessary. Several treatments may be required, including orthodontics or tooth straightening, cosmetic, as well as advanced implantology. It is very easy and convenient to choose the fast treatment  track, but the correct line or lines of treatment alawys provide the best and most durable dental outcome.

CASE SCENARIO

A young healthy patient in his late teens presents himself with malaligned teeth and a small or unusually shaped front tooth. The patient complained about his smile, saying he had a missing tooth, another ‘smallish’ looking tooth and poor-looking remaining teeth. The remaining teeth were actually in good shape and health but were crammed together, trapping food and causing his gums to become inflamed.

The initial phase dealt with straightening both his upper and lower teeth, aligning them in the correct position with each other, supporting his lips and cheeks accordingly. This treatment involved fixed braces for 12 to15 months. The space present of the missing tooth – the right lateral incisor – was widened to accommodate the exact dimensions of a normal lateral incisor tooth. The small tooth (or microdont) – the left lateral incisor – was also moved into its correct position allowing for future rebuilding cosmetic work.

The second phase of treatment was the placement of a dental implant in the position of the missing right lateral incisor. Since this tooth was a genetically missing tooth, the normal bone volume usually present was also missing. Therefore, a simultaneous holistic approach is necessary. Several treatments may be required, including orthodontics well as advanced implantology. It is very easy and convenient to choose the fast treatment treatment always provide the best and most durable dental outcome.

The bone graft was placed around the implant. This was allowed to heal for four months. During this time the orthodontic treatment was completed.

The third phase of treatment was to remove the fixed brace and take an impression of the implant and the microdont to produce an crown and a veneer respectively. The implant crown was screw-retained onto the implant while the veneer was cemented onto the microdont. Both restorations were constructed with all-ceramic metal-free porcelain maximizing the aesthetic result.

The final phase was to place a retainer on the teeth, inhibiting them from further movement and allowing them to solidify in their final correct position. In the lower arch, a thin stainless steel metal wire was attached to the back of the lower six teeth, while in the upper arch, a clear retainer or tray was constructed to be worn at night for a further six months. The patient was placed on a review programme and seen every six months.

The final result is exactly what the patient expected: a normal-looking, inconspicuous smile with a predictable long-term outcome, including a major boost in confidence levels. Ask your dentist!