Have several separate problems been quoted separately?
Treatment plans usually present broken back teeth, decay and a discolored smile as three treatments with three timelines, and treated that way they interfere with one another. Examined together they are one sequence, and the parts that have to heal before the others can begin decide that sequence. Send us a photo of your smile and we will tell you what a complete plan would involve.
- A call within two hours during office hours.
- A written cost from us, before you commit to anything.
- No obligation. Many patients take weeks to decide. That is normal.
What this case cost
$813/month
144 payments at 9.99% APR, on approved credit.
Total: $68,000 for three extractions, three implants, three implant crowns and seventeen porcelain veneers.
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Treatment Plan by Dr. Mehdizadeh
- Assessment of every problem in both arches before any treatment began.
- Removal of two fractured teeth and one failed root canal at the back of the mouth.
- Three implants placed, two in the upper arch and one in the lower.
- Eight weeks of healing before we made any restoration.
- Three implant crowns and seventeen porcelain veneers in e.max, designed as one set.
- A night retainer to protect the restorations from continued grinding.
The Patient's Journey
This patient arrived with several separate complaints. He had broken teeth toward the back of his mouth, he wanted a more comfortable bite, and there was decay that needed removing before we could consider anything else. He also wanted his smile improved, which was the last item on his list.
The photographs show the appearance problem clearly enough. The teeth showed discoloration, the proportions were uneven, and dark spaces interrupted the smile line. What the photographs do not show is the condition of the back teeth, which is where the treatment actually began.
Understanding the Challenge
Presented individually, these were three separate treatments with three separate timelines and three separate estimates. Treated that way, they interfere with one another, because we make restorations at the front to meet the teeth at the back, and remaking the back afterwards means remaking the relationship the front restorations depend on.
There was also a fixed constraint on the sequence. The two fractured teeth and one tooth with a failed root canal had to come out, and the implants replacing them require approximately eight weeks in the bone before they can carry a restoration. We could not finish anything at the front during that interval, because the finished bite depends on what the implant crowns will eventually contribute to it.
List every problem in both arches before beginning anything. Remove the unrestorable teeth and replace them with implants. Allow the implants to integrate before designing the restorations. Correct the bite and the appearance in a single design. Protect the completed restorations from continued grinding.
How We Approached Treatment
Dr. Mehdizadeh's assessment covered both arches and produced a written list of everything that required attention, including the problems the patient had not come in about. That list became the treatment plan, and the patient agreed to the whole plan before the first extraction.
Dr. Mehdizadeh removed the two fractured teeth and the tooth with the failed root canal, and placed three implants at those positions, two in the upper arch and one in the lower. Eight weeks of integration followed. During that interval the design work continued, because we could establish the proportions of the finished restorations from the records while the implants healed.
Our master ceramist then made twenty restorations as a single set, all in e.max in our own laboratory: three implant crowns and seventeen porcelain veneers, with eight veneers and two implant crowns in the upper arch and nine veneers and one implant crown in the lower.
Designing them together let us correct the bite and the appearance at the same time. We did not match the implant crowns to finished veneers or design the veneers around finished crowns; we specified every unit against the same completed plan.
The Result After Twelve Weeks
Implants have replaced the broken teeth, the decay is gone, the proportions are even across both arches, and the bite now rests on twenty restorations designed to share it. Eight appointments across twelve weeks covered the extractions, the implant placement, the integration period, the design and the final cementation of every unit.
There is no outstanding treatment on his list. He wears a retainer at night and maintains a routine recall schedule. Implants do not decay, but they can lose the bone and tissue surrounding them, and the regular examinations and cleanings check for exactly that.
Frequently Asked Questions About Implants, Full Mouth Veneers and Comprehensive Treatment
Why treat everything at once instead of one problem at a time?
Because we make restorations at the front to meet the teeth at the back. Rebuilding the back afterwards means rebuilding the relationship the front restorations depend on, so you would have to repeat or compromise the work at the front.
How long does an implant take before a crown can be fitted?
We allowed approximately eight weeks of integration in this case. The interval depends on the quality of the bone and on the stability achieved at placement, and we assess it rather than assume it.
Can the waiting period be shortened?
In selected cases we can restore an implant earlier, depending on bone quality and the stability achieved at surgery. It is a judgment made case by case, and compressing the interval where the conditions do not support it produces an implant restored before it is ready.
Why were the broken teeth removed rather than repaired?
Two had fractured beyond the point where a restoration retains anything, and one had a failed root canal. We replace a tooth that cannot hold a restoration predictably rather than patching it repeatedly.
What is the difference between an implant crown and a veneer?
An implant crown replaces a whole tooth and sits on an implant in the bone. A veneer rebuilds the visible surface of a tooth that is still present. This case used three of the first and seventeen of the second.
Why were the implant crowns and the veneers designed together?
Because designing them separately means matching one to the other after the fact, and an implant crown matched to finished veneers has to reproduce decisions it played no part in. Specifying every unit against the same completed plan avoids that.
Was the bite actually improved, or only the appearance?
Both, and the bite was the reason for the sequence. Replacing the missing back teeth restored the support the bite had lost, and we designed the twenty restorations to distribute the load rather than concentrate it on whichever teeth remained.
Does having implants mean more maintenance?
It means the same examinations matter more. Implants do not decay, but they can lose the bone and tissue surrounding them, and you will not feel that loss; we detect it at routine visits.
Is a night retainer necessary after this kind of treatment?
Where grinding is present, yes. It is a thin appliance worn during sleep, and it absorbs the load the restorations would otherwise carry.
How much does comprehensive treatment like this cost?
This case was $68,000, covering three extractions, three implants, three implant crowns and seventeen porcelain veneers. $813/month: 144 payments at 9.99% APR, on approved credit.
