FULL-MOUTH IMPLANT PLACEMENT AND FIXED PORCELAIN RESTORATIONS – THE JOURNEY TO RESTORE CHEWING FUNCTION AND A NEW SMILE FOR PATIENT LEANNE SWAN

Full or partial tooth loss accompanied by significant dental tissue damage, malocclusion, and bone resorption presents a major challenge in restoring both oral function and aesthetics. Implant placement with fixed restorations is a widely used and effective solution but requires a strict clinical protocol—especially for international patients with limited treatment time.

This article presents a case of full-mouth rehabilitation using dental implants and fixed porcelain restorations for a 57-year-old female patient from Australia, suffering from multiple tooth loss, severe caries, and a misaligned bite. The treatment was carried out in two phases—surgical and prosthetic—with an initial stay in Vietnam of 10 days.

Once self-conscious about her smile due to broken teeth, tooth loss, and a misaligned bite, Leanne Swan—a 57-year-old woman from Australia—came to Herident in search of comprehensive functional and aesthetic improvement. Her primary desire was to restore her missing teeth and regain a confident smile. She chose full-mouth implant placement with fixed porcelain restorations. Under the care of Dr. Dang Trieu Hung, the treatment was carried out systematically and meticulously—from removing damaged teeth and root canal treatments to implant placement and aesthetic restorations. After the initial 10-day treatment, Leanne experienced noticeable improvements in chewing function and was delighted with her brand-new smile.

Attending doctor: Dr. Dang Trieu Hung, PhD

Dr. Hung is reviewing the patient's X-rays

Following the preliminary examination, the patient presented with the following:

Upper Jaw: The front teeth protrude outward, causing facial imbalance and affecting the bite, leading to deep bite — a common type of malocclusion in which the upper front teeth excessively overlap the lower front teeth. Some of the anterior teeth had previously been restored, but the results were not long-lasting: the margins became open, recurrent decay developed under the old restorative material, and there were signs of discoloration, significantly affecting aesthetics. Additionally, several other teeth in the upper arch showed signs of extensive decay and structural fractures, leaving the teeth weakened and lost tooth, resulting in a lack of proper alignment and cohesion within the dental arch.

Lower Jaw: Crowding of the anterior teeth significantly hinders oral hygiene, creating favorable conditions for development of tooth decayMany teeth severe decay and structural fractureswith the coronal structure of the teeth almost entirely compromised. In some areas, only the tooth roots remain or the teeth are completely missing, leading to an imbalance in occlusal force distribution. Additionally, several lower teeth still have old amalgam fillings, which no longer provide proper adhesion, show marginal leakage, are unaesthetic, and may negatively affect the surrounding tooth structure.

Intraoral condition as observed on the X-ray film:

The 3D cone-beam CT scan reveals signs of bone resorption in the upper jaw, particularly in areas where teeth have been missing for a long time. This necessitates careful consideration of bone volume and density when planning for implant placement. In contrast, the lower jaw shows relatively well-preserved bone height and width at the edentulous sites, providing favorable conditions for implant placement without the need for additional bone grafting.

3D Imaging of the Patient’s Initial Condition

Panoramic Radiograph Showing the Patient’s Initial Condition

The patient had no systemic disease, was in good general health, cooperative, and highly motivated to receive definitive treatment without delay.

After thorough clinical examination and precise measurements on the radiographs Conebeam CT, Dr. Hung proposed an interdisciplinary treatment plan to restore function, aesthetics, and preserve the remaining natural teeth as much as possible, as follows:

• Extraction of retained root stumps and root canal treatment for teeth that are still restorable

• Place 4 implants at suitable places (upper and lower jaws)

• Full-mouth fixed porcelain restoration to correct malocclusion, enhance aesthetics, and ensure proper chewing function.

Step 1: Intraoral scanning, clinical photography, and radiographic imaging.

Step 2: Detailed evaluation of the patient's dental status through X-ray imaging Conebeam CT to assess the condition of both jaws’ bone structure as well as the remaining teeth.

Step 3: Consult with the patient and adjust the treatment plan based on systemic health, local oral condition, and the patient’s expectations.

Step 4: Extract retained root stumps and perform root canal treatment on teeth with periapical inflammation.

Step 5: Temporary Crown (if needed) Placement of 4 implants in the upper jaw. The implant surgery was performed in a sterile environment. The patient was closely monitored throughout the procedure, with special attention to heart rate and blood pressure, and received intravenous analgesia for pain management during the operation.

Step 6: Remove amalgam connection, and placement of temporary full-mouth porcelain restorations.

Step 7: Three months post-implant placement, the patient will undergo a follow-up examination to assess osseointegration and overall treatment success, followed by the fabrication and placement of fixed prosthetic crowns on the implants.

After the initial 10-day treatment phase, most of the patient’s major concerns were addressed:

4 implants were successfully placed in both jaws with good healing.

Severely decayed and broken teeth were treated and restored. The arches were aligned, and the deep bite was corrected.The patient's smile aesthetics improved significantly.

Final result after porcelain and implant restorations

Throughout her treatment at Herident Dental Clinic, the patient received attentive care and close monitoring throughout the process. After the placement of full-mouth ceramic crowns, their smile was completely transformed, and they expressed great satisfaction with the results. The patient is expected to return to Vietnam in 3 months for the final prosthetic restoration on the implants and to evaluate the post-treatment outcome.

At Herident Dental, we take pride in delivering dental implant services through a highly professional and state-of-the-art treatment protocol.

Herident Dental specializes in advanced implant treatments, aesthetic restorations, and modern orthodontics, with a strong focus on integrating digital technology in diagnosis and treatment planning. Backed by a team of highly experienced doctors, international-standard equipment, and a comprehensive patient care protocol, Herident is committed to delivering excellence in every smile.