One of the most unique full mouth reconstructions we ever performed was done in the summer of 2005. A teenage boy named Dhanesh came to us with one of the most severe cases of missing teeth we had ever seen. Unlike many children who lose their teeth to decay, poor hygiene, or sports accidents, this young man had been born with 14 of his permanent teeth missing!
His family dentist was baffled by this, and considered the possibility that the teeth had failed to form as a result of some odd genetic condition. Believing this to be beyond the scope of his services to remedy, the family dentist had referred to young man to Dr. Campbell for a full mouth reconstruction using cosmetic dental implants and fixed bridgework.
We began by taking x-rays of the boy's jaws to determine their general health, and to see if there was sufficient mass in which to secure dental implants. In typical cases where people have lost teeth to decay or accidents, the bone that normally surrounds tooth roots begins to recede. When jaws become deteriorated beyond a certain point, implant dentistry becomes more complicated.
We often have to use a combination of dental implants and fixed porcelain bridges to fully reconstruct a set of teeth. Ideally, we try to use the dental implants themselves, not natural teeth, as the anchors for the bridges. We do this to avoid putting stress on natural teeth that could result in damage to the enamel and subsequent vulnerability to tooth decay.
In the Dhanesh's case, we had to make some exceptions. Some of his natural, permanent teeth had come through, but they had emerged at random places along his jaw. Almost all of them were irregularly shaped and would require dental crowns to look natural and healthy. We took casts of the few teeth that were of normal shape and size, and we determined with size and shape of dental implants and porcelain crowns to use in the full mouth reconstruction.
Because Dhanesh needed so many implants, and because he needed them on both the upper and lower jaws, we performed the surgical phase of the procedure in a series of stages. Dhanesh had the advantage of youth on his side and healed very quickly after each round of implantation.
When it came time for the cosmetic phase of the procedure, we capped his natural teeth with porcelain crowns identical to the ones that we used to cap the titanium implants. We then placed bridges in key locations, some anchored to the natural teeth, but mostly anchored as much as possible to the new dental implants.
Although Dhanesh was indeed born without some of his permanent teeth, on the other hand, he apparently was born with a sense of perfect timing. On the day we completed the last of his bridgework with the final porcelain crown, Dhanesh told our staff that the very first public photograph of his new smile would be taken later that evening-on location at his senior prom.
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