I think my treatment was unsuccessful. I am unhappy about the situation in my mouth. I have a high smile line. Perhaps insufficiently bone was removed? I now have a large overbite, I can not put lips together, transition between dentures and gingiva is visible. I can not laugh, eat, drink, talk. My face is completely different, I look like a horse. It is still temporary. It is possible to improve it through better prosthetics? Is there any solution?
Answer: All on Four has alternatives Some cases are much more challenging than others. In this case, the transition line is an issue. While it may seem obvious that bone could/should have been reduced, this often leads to insufficient bone to use for implants. A great alternative is the Deutsch Removable Bridge. This can use the existing implants that are used for the All on Four, but since it is removable, there can be some material that extends to hide the transition line. This would NOT be a good idea if the restoration was screwed in place (only removed at the dentist office), but is easily cleansed with the DRB.It functions and FEELS like a screwed in arch (like the All on Four), but is maintained much more easily.
Helpful 1 person found this helpful
Answer: All on Four has alternatives Some cases are much more challenging than others. In this case, the transition line is an issue. While it may seem obvious that bone could/should have been reduced, this often leads to insufficient bone to use for implants. A great alternative is the Deutsch Removable Bridge. This can use the existing implants that are used for the All on Four, but since it is removable, there can be some material that extends to hide the transition line. This would NOT be a good idea if the restoration was screwed in place (only removed at the dentist office), but is easily cleansed with the DRB.It functions and FEELS like a screwed in arch (like the All on Four), but is maintained much more easily.
Helpful 1 person found this helpful
Answer: Visible Transition Line for All-On-4 Thank you for posting your question and photos. Based on the information you have shared, it appears that you are correct in your assessment that the transition line is visible due to inadequate bone reduction. Your "before" photos show that you have a very high smile line. Cases such as yours require careful consideration, especially to avoid showing the transition line. To avoid showing the transition line in cases such as yours with very high smile lines, significant bone reduction is often required (much more than the average case). In order to reduce such a large amount of bone, a few things must be considered. 1) how much bone will be left once you reduce enough bone to avoid showing the smile line; 2) will this bone reduction put you into the sinus? If so, it will need to be lifted during the bone reduction.
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Answer: Visible Transition Line for All-On-4 Thank you for posting your question and photos. Based on the information you have shared, it appears that you are correct in your assessment that the transition line is visible due to inadequate bone reduction. Your "before" photos show that you have a very high smile line. Cases such as yours require careful consideration, especially to avoid showing the transition line. To avoid showing the transition line in cases such as yours with very high smile lines, significant bone reduction is often required (much more than the average case). In order to reduce such a large amount of bone, a few things must be considered. 1) how much bone will be left once you reduce enough bone to avoid showing the smile line; 2) will this bone reduction put you into the sinus? If so, it will need to be lifted during the bone reduction.
Helpful 2 people found this helpful
April 28, 2016
Answer: All-on-4 Thank you for sharing your experience. Upon an evaluation, I would recommend a CT scan is done to evaluate height of bone, and depending on bone availability, the implants would have to be removed. Significant bone reduction would have to take place and new implants would need to be placed in a much higher level so the gingival transition line would be positioned higher, therefore being hidden upon smiling. I would recommend that this is done under IV sedation (our office offers a variety of sedation techniques) to make your experience as pain-free as possible and comfortable for you.
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April 28, 2016
Answer: All-on-4 Thank you for sharing your experience. Upon an evaluation, I would recommend a CT scan is done to evaluate height of bone, and depending on bone availability, the implants would have to be removed. Significant bone reduction would have to take place and new implants would need to be placed in a much higher level so the gingival transition line would be positioned higher, therefore being hidden upon smiling. I would recommend that this is done under IV sedation (our office offers a variety of sedation techniques) to make your experience as pain-free as possible and comfortable for you.
Helpful
April 24, 2016
Answer: All on 4 prosthetics redo? My first question based on your "before" photo is "why did you have your teeth extracted and all on 4 done?"My second question is "did you go to a specialist(s) to have this done?"For the first question, I'm going to guess that your crowns may have been failing and redoing them was uncertain. I say this because it does not appear to me as though you lost your teeth to gum disease or bone loss. For the second question, I'm going to "bet the barn" that you did not go to a specialist for this. No specialist (periodontist/oral surgeon/ or Prosthodontist) would have allowed you to have All On 4 with a case of a gummy smile such as you have. Whoever did this unfortunately misdiagnosed your case and as a result your treatment went in an awkward direction. Please see a specialist either in Prague or another European major city centre (if at all possible) to asses where to go from here. Without X-rays, I could not possibly give you any advise and would. It be fair to you. If you resubmit your X-rays, I would definitely give you a better direction. I wish you well in your endeavours with this. I wish things didn't turn out like this for you.
Helpful 1 person found this helpful
April 24, 2016
Answer: All on 4 prosthetics redo? My first question based on your "before" photo is "why did you have your teeth extracted and all on 4 done?"My second question is "did you go to a specialist(s) to have this done?"For the first question, I'm going to guess that your crowns may have been failing and redoing them was uncertain. I say this because it does not appear to me as though you lost your teeth to gum disease or bone loss. For the second question, I'm going to "bet the barn" that you did not go to a specialist for this. No specialist (periodontist/oral surgeon/ or Prosthodontist) would have allowed you to have All On 4 with a case of a gummy smile such as you have. Whoever did this unfortunately misdiagnosed your case and as a result your treatment went in an awkward direction. Please see a specialist either in Prague or another European major city centre (if at all possible) to asses where to go from here. Without X-rays, I could not possibly give you any advise and would. It be fair to you. If you resubmit your X-rays, I would definitely give you a better direction. I wish you well in your endeavours with this. I wish things didn't turn out like this for you.
Helpful 1 person found this helpful
December 7, 2018
Answer: Transition zone Better prosthetics may solve the situationbefore going to the final i would ask your dentists to make new temporary teeth, this time without the pink. If you are happy with those then the final prosthesis can be made in zirconia.Wish you all the best
Helpful 2 people found this helpful
December 7, 2018
Answer: Transition zone Better prosthetics may solve the situationbefore going to the final i would ask your dentists to make new temporary teeth, this time without the pink. If you are happy with those then the final prosthesis can be made in zirconia.Wish you all the best
Helpful 2 people found this helpful
