Overcoming the challenges of full arch restorations – Martin Wanendeya and Nik Sisodia

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  Posted by: Dental Design      1st January 2019

Thanks to advances within the profession, patients can now choose from a wide range of treatments that enable them to replace broken or lost teeth. Dentures have long been a go-to solution for missing teeth due to their affordability, but in recent years, they have dropped out of favour among many patients. Some traditional dentures are typically known to move – causing painful irritation of the gingiva – and they are also associated with the maintenance hassle of having to frequently remove the denture for cleaning. As patients have sought a more permanent solution, dental implants have become an optimal restorative option, offering high aesthetics and durability.  

For those who suffer from complete edentulism, full arch restorations with the use of dental implants – otherwise known as ‘fixed teeth in a day’ – can prove invaluable. One of the major benefits of this treatment is the fact that patients can visit a dental practice requiring a single or double arch replacement, and walk out of the clinic with a natural-looking, reconstructed smile that very same day. Patients are able to benefit from a fixed solution that can offer truly desirable aesthetics. However, make no mistake that full arch restorative cases can often present complex challenges that practitioners must overcome in order to ensure a highly satisfactory result.

This was a hot topic of discussion at this year’s British Academy of Cosmetic Dentistry (BACD) Annual Conference. Renowned implantologists, Dr Nikhil Sisodia and Dr Martin Wanendeya, led a fantastic lecture on the past, present, and future methods of constructing full arch restorations through digital planning, with an emphasis on aesthetics and function.

“Traditionally, full arch implant treatments were carried out using porcelain,” Dr Wanendeya explained. “However, as a result of bone and soft tissue loss, patients often ended up with unattractive restorations that featured very long teeth. Practitioners then began exploring pink aesthetics for full arch implant work, which involved using pink gum and white teeth in order to create natural aesthetics. The advantage of using this method is that practitioners are able to achieve consistent results, by artificially controlling the position of the gum, the shape of the gingival margin, and the height of the interproximal papillae.

“The disadvantage of this method is that, in certain cases, you have to remove a large amount of bone and soft tissue through osteoplastic procedures in order to move the transition line – where the pink artificial gum meets the pink natural gum – to an area beyond the patient’s smile line. However, with the advent of new technology, we are able to maintain a workflow whereby we can preserve the natural pink architecture in certain cases and place white teeth on top (i.e. a full arch restoration without any artificial pink gum).” 

During their lecture, Dr Wanendeya and Dr Sisodia explored the ways in which full arch restorations have been carried out in the past, highlighting problems that they had previously encountered and the solutions they came up with to overcome them. They also discussed the current possibilities of using digital technology and treatment planning to prepare and restore full arches with natural-looking pink gums and white teeth.

“We hope delegates have realised that with appropriate treatment planning and placement of restorations, it is possible to preserve valuable bone and soft tissue when placing implants in full arch restorative cases,” said Dr Sisodia. “We also hope delegates will consider osteoplastic procedures only if it is relevant to the patient, and not because it is a more straight-forward treatment option. Dentists should be able to implement digital treatment planning within their own professional workflows.”

Dr Wanendeya commented: “Producing a full arch restoration with the best aesthetic outcome is the holy grail of digital implant dentistry and this is something that many practitioners aim to do successfully. Modern technology offers us various advantages in terms of diagnosis, treatment planning, and the delivery of a full arch prosthesis. There are huge benefits to digital treatment planning in many implant restorative cases, which is why I think it is such a hot topic at the moment.”

As owners of the award-winning Ten Dental Facial referral clinic, Dr Sisodia and Dr Wanendeya were delighted to take the stage and share their professional insight at the BACD Fifteenth Annual Conference. They remain dedicated to helping clinicians excel in practice, which is why they look forward to another year of offering implant restorative training and surgical mentoring through their own dedicated Implant Restoration Course. Be sure to contact the team at Ten Dental Facial for further details.


For more information about Ten Dental Facial and The Implant Restoration Course visit Facebook/Implant Restoration Course-IRC, email:office@tendental.com, visit www.implant-restoration.comor call 020 7622 7610


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