Wednesday, September 19, 2018

Etelka's Smile Transformation Using Digital Dentistry

How our team of Dentists, Specialists and Digital Dentistry restored Etelka's smile and dental function.

Etelka grew up in Europe and had a lot of dental work as a child. After moving to Canada, she had further extensive dental procedures throughout her adult life, then came to Dentistry on Dundas in 2016. She was quite frustrated and self conscious about her oral condition and was committed to making a permanent change. This would include a multifaceted collection of procedures including periodontal surgery, Root canal therapy, orthodontics, fillings, dental implants and crowns. This was done by various specialists, including myself, Dr. Dana Levy, Periodontist and Dr. Mark Librach providing orthodontics.

Dr. Lanys:

1. Why was Etelka a good candidate for these procedures? She was an excellent candidate for this lengthy and comprehensive treatment plan. She was ready, eager and committed to creating an oral state of health which was aesthetically pleasing.

2. What were her biggest concerns about the procedure? Etelka had many concerns. She wanted to keep all her existing teeth and replace all missing teeth with implants. She did not want her upper anterior bridge any longer; for there was food impaction and she did not like the way it looked. She had an extremely "high demanding" job in downtown Toronto and wanted only evening appointments.




3. How did you develop a plan for treating Etelka’s concerns? Etelka's concerns were rather challenging but definitely not impossible. There were compromises to be made and the main one was that the course of treatment was going to be lengthy and extensive. The treatment plan was devised with our team of professionals and specialists. There was a specific order of procedures that was essential to follow to ensure the best possible results.

                           Cone Beam Implant mapping Dr. Librach

4. Was her treatment out of the ordinary? The treatment was not out of the ordinary. All aspects of her treatment were quite routine. The challenge was that almost every tooth had to be treated or retreated. This was superimposed with a difficult "bite" that had to be corrected with braces. It was, therefore, all "ordinary", however, just a lot of timely "ordinary" work.

5. How long did Etelka’s transformation take? The entire course of treatment was approximately two and a half years.

6. What steps do these procedures involve? The order of steps was very important. Initially, there were various consultations, x-rays and exams in the different disciplines. Periodontal and restorative were necessary first. This would include cleaning, pocket reduction, fillings and extractions of hopeless teeth. Bone grafts were placed in those areas to prepare for implants. Lower braces were then placed to upright the teeth to create a more favorable bite to ensure the implants and crowns were in the correct positions. After the bone grafts healed for approximately 4 months, the implants were placed and also had to heal for a subsequent 4 months. Finally, all the crowns were placed.

                       Digital imaging for crown restorations, 5Axis

7. Is there an ideal candidate for these procedures? The ideal patient for this full mouth reconstruction must be committed emotionally, physically and must put in the time. Most patients have partial treatment of this kind or just a few procedures of this nature which is rather quick and routine.

8. Are there any at-home steps patients should follow after procedures like these? Once any treatment of any kind is completed, it is up to the patient to maintain a healthy and regular regime of home care with excellent oral hygiene, and also return for regular maintenance visits to the dental office. Quite often a night guard is recommended to protect the teeth from wear and keep the jaw in a good state.


9.What advice would you give those debating whether or not to get dental surgery? I would recommend that anyone who wants to make a change for the better regarding any aspect of their health, to investigate all options and find the doctor that is right for them. In most cases, there is nothing more rewarding than watching a patient look in the mirror and seeing the look on their faces when they see the reveal!

Dr. Levy:

For our patient Etelka we provided different forms of treatment which included overall thorough Periodontal therapy which would provide a healthy foundation for all future prosthetic treatment. Among those treatments were included: deep cleaning of the gum pockets, antibiotic therapy, home care and physiotherapy, regeneration of advanced bone loss, extraction of teeth that were deemed non-treatable as a result of either decay or Periodontal (gum) disease.

1. Why was Etelka a good candidate for these procedures? Etelka was an excellent candidate since she was healthy, non smoker and very keen to achieve maximum results with a deep commitment to achieving all of our objectives.
2. What were her biggest concerns about the procedure? The biggest concerns were, of course, pain or discomfort, time to recover, making sure her teeth and replacements provided excellent aesthetics during all procedures.
3. How did you develop a plan for treating Etelka’s concerns? our treatment plan is always developed as a team approach: each practitioner does a comprehensive clinical exam, followed by any additional imaging or study models which will allow us to then brainstorm together which options are best for our patient, from good to better to best.
4. Was her treatment out of the ordinary? Treatment was not out of the ordinary as more and more adults which have had dental treatment done through their adult years, is starting to break down and the demands for proper treatment and oral health are higher, both from the patients perspective and the dental professionals.
5. Is there an ideal candidate for these procedures? Ideal candidates are always patients who are healthy and under regular care of their medical doctor as well as their dentist. Of course, non smokers will always achieve great results and patients tat are committed to having a healthy mouth will always be those who will see the outcomes which are hoped for from the outset.
6. Are there any at-home steps patients should follow after procedures like these?  patients receiving this and any type of complex dental care must know that proper home are and physiotherapy as well as frequent maintenance visits to the dental office are imperative in order to maintain the achieved outcomes and maintain healthy foundations for their prosthetic reconstruction.
7. What advice would you give those debating whether or not to get dental surgery? In order for patients to commit to complex care, it’s important to measure patients desires, objectives and realistic outcomes. Overall, wanting to achieve a beautiful smile and proper function, will require time commitment and perseverance as well as the knowledge that what took many years to occur, will not be resolved in one or two appointments. However, the ultimate result will far outweigh the hard work on behalf of their dentists and dental specialists and of course the hard work of each and everyone of our patients.

                                     Dr. Michelle Lanys, Dentist

                                     Dr. Dana Levy, Periodontist

                                   Connie, Treatment Coordinator

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