Comprehensive Approach to Upper and Lower Anterior Teeth Removal with Lower Bridge and Upper Implants with Temporary Denture

The management of anterior teeth requiring extraction, especially when combined with prosthetic rehabilitation, requires careful planning to balance function, esthetics, and patient comfort. A treatment plan involving the removal of both upper and lower anterior teeth, placement of a lower bridge, upper implants, and a temporary denture is a complex but effective approach.

Indications for Treatment

Patients may require this comprehensive approach due to:

• Severe periodontal disease leading to mobility or bone loss.
• Extensive decay or trauma affecting anterior teeth.
• Esthetic concerns affecting smile and social interactions.
• Need for functional restoration of bite and occlusion.

Step 1: Pre-Operative Assessment

A thorough evaluation is essential, including:

• Clinical Examination: Assess periodontal status, tooth mobility, occlusion, and esthetic requirements.
• Radiographic Analysis: Panoramic and periapical radiographs to evaluate bone quality and quantity for implants.
• Medical History: Identify systemic conditions that may impact healing or anesthesia.
• Patient Expectations: Discuss esthetic outcomes and temporary prosthetic options.

Step 2: Tooth Extraction

• Upper and Lower Anterior Teeth Removal:
  Extractions are performed atraumatically to preserve alveolar bone for future implant placement and bridge support. Care is taken to avoid excessive trauma, particularly in the anterior maxilla, which is critical for esthetics.
• Hemostasis and Socket Management:
  Socket preservation techniques, such as grafting, may be used if significant bone resorption is anticipated.

Step 3: Lower Bridge Fabrication

• Preparation of Abutments:
  Adjacent teeth are prepared to support a fixed dental bridge.
• Impression and Temporary Bridge:
  An impression is taken immediately after extractions to fabricate a temporary bridge, restoring function and esthetics during healing.
• Bridge Placement:
  The permanent lower bridge is planned following adequate healing of extraction sites, usually after a few weeks.

Step 4: Upper Implant Placement

• Implant Planning:
  Using radiographs or CBCT scans, the number and position of implants are planned to optimize support for the final prosthesis.
• Surgical Procedure:
  Implants are placed into the anterior maxilla under sterile conditions, ensuring primary stability.
• Healing Phase:
  Osseointegration typically requires 3–6 months. During this time, a temporary denture is used to maintain esthetics and function.
• Step 5: Temporary Denture
  • Immediate Temporary Denture:
    Fabricated to fit immediately after extractions, providing support to soft tissue and esthetic appearance.
  • Adjustment Period:
    Dentures are adjusted for comfort, speech, and function. They act as a transitional prosthesis until implant-supported crowns can be placed.

  Step 6: Final Prosthetic Restoration

  • Lower Bridge: Permanently cemented onto prepared abutments.
  • Upper Implant Prosthesis:
    Following osseointegration, implant crowns or a fixed bridge is attached to upper implants.
  • Occlusal Adjustments:
    Fine-tuning ensures a harmonious bite and long-term function.

  Advantages of This Approach

  • Restores esthetics and smile confidence immediately with temporary solutions.
  • Preserves alveolar bone with careful extraction and socket management.
  • Provides long-term stability with lower bridge and upper implants.
  • Minimizes patient discomfort with staged rehabilitation.

  Considerations and Risks

  • Surgical risks such as infection, bleeding, or implant failure.
  • Temporary denture may require frequent adjustments.
  • Healing times vary depending on bone quality and patient health.

O post Dental bridge or Dental Implant apareceu primeiro em Forma Smile | Dentist in London - Dental Clinic London - Invisalign Clinic in London - Invisalign Specialist - Dental Implants in London - Dental Care - Dental Boutique based in Central London EC2.

This patient’s metal ceramic crowns had been in place for two decades. They were leaking, discolored, and making her feel self-conscious about her smile. She came to us looking for a solution that would last.

We replaced them with premium zirconium crowns—and the transformation is remarkable.

What changed:

• Superior color matching using advanced shade selection

• Shortened lengths for a more natural, youthful proportion

• Refined contours for a softer, more feminine aesthetic

• Biocompatible zirconium eliminates the dark line at the gum

• Natural translucency that catches light beautifully

• Sealed margins prevent future leakage and decay

Why zirconium is the upgrade:

Zirconium crowns are the gold standard for front teeth. They’re significantly stronger than traditional metal ceramics, look completely natural, and last 15+ years with proper care. No metal means no dark shadows, no allergic reactions, and no leakage compromising your teeth underneath.

If your crowns are showing their age, you don’t have to live with them. A consultation with Dr. Kumar takes 30 minutes and could transform how you feel about your smile for the next two decades.

Book confidentially. Hablamos español con fluidez.

#ZirconiumCrowns #SmileMakeover #DentalCrowns #CosmeticDentistry #NaturalSmile #DentalTransformation #FormaSmile #CentralLondon #DentistryExcellence #FeminineSmile

O post Replacing tired old crowns apareceu primeiro em Forma Smile | Dentist in London - Dental Clinic London - Invisalign Clinic in London - Invisalign Specialist - Dental Implants in London - Dental Care - Dental Boutique based in Central London EC2.

Bridges vs Dentures: Why Fixed Solutions Change Lives** Our patient wore an old acrylic denture for years—it had a large palatal overhang that affected her speech, dropped when eating, and looked unnatural. She deserved better. **The Solution:** A 10-unit zirconium bridge fixed on 4 upper premolars.

**Why bridges win:** ✓ Fixed permanently—no movement, no dropping ✓ Natural speech and phonetics restored ✓ Eat confidently without worry ✓ Superior aesthetics with natural appearance ✓ Better oral hygiene—no hidden food traps ✓ Improved confidence and quality of life

**Our Process:** We prepared 2 premolars and restored 2 others, then fitted a temporary PMMA bridge for 4 weeks to test function, aesthetics, and speech. Once perfected, we placed the permanent zirconium bridge. The transformation? Life-changing. Dentures have their place, but when you can restore with a fixed bridge, the patient experience is incomparable. Advanced planning, precision preparation, and quality materials make all the difference.

Ready to explore your options? Book a consultation. We’re here to help you smile with confidence. #DentalBridges #SmileMakeover #AdvancedDentistry #ZirconiumBridge #DentalSolutions #FormaSmile

O post When a bridge is alternative to a denture or implants apareceu primeiro em Forma Smile | Dentist in London - Dental Clinic London - Invisalign Clinic in London - Invisalign Specialist - Dental Implants in London - Dental Care - Dental Boutique based in Central London EC2.

Restoring the Smile & Occlusion with Zirconium Crowns 🦷✨ At Forma Smile, we believe every smile tells a story—and sometimes that story needs a beautiful chapter of restoration. This case showcases the transformative power of full-mouth zirconium crown restoration. Our patient came to us with compromised dentition affecting both aesthetics and function. Through careful planning and precision execution, we restored not just the appearance, but also the proper occlusion and bite alignment.

We placed 2 upper and 3 lower Zirconium crowns to restore the occlusion. It took 2 visits.

Why Zirconium Crowns? ✓ Superior strength and durability ✓ Natural aesthetic appearance ✓ Biocompatible with gum tissue ✓ Long-term stability and reliability ✓ Ideal for complex full-mouth cases This patient now enjoys a confident smile, improved chewing function, and restored oral health—all achieved through advanced restorative dentistry and meticulous attention to detail.

Ready to restore your smile? Book a consultation with Dr. Raj Kumar and discover how zirconium crowns can transform your dental health. #RestorativeDentistry #ZirconiumCrowns #SmileMakeover #DentalRestoration #AdvancedDentistry #FormaDental #CentralLondon

O post How to restore the bite when teeth have shifted apareceu primeiro em Forma Smile | Dentist in London - Dental Clinic London - Invisalign Clinic in London - Invisalign Specialist - Dental Implants in London - Dental Care - Dental Boutique based in Central London EC2.

1. Experts in our area

With over 30 years’ experience in dentistry, cosmetic dentistry, Invisalign & Implantology you are in very experienced hands. Here at Forma we offer a personal tailor-made experience in a stress-free, relaxing environment and using the most advanced dental and cosmetic treatments currently available.

2.Variety of different dental treatments offered

Invisalign – Forma has provided Invisalign invisible braces for over 15 years, we have successfully treated over 1100 patients. With Invisalign clear aligners it’s easy to achieve the perfect smile with minimal impact to your lifestyle. With custom-made aligners that you change every 2 weeks yourself at home and check-ups every 6-8 weeks, having your teeth straightened could not be easier. We’re confident in the technology Invisalign’s clear braces provides and our patients are always satisfied with their finished smile.

Implants – With the most up to date technology and full assessment including CT & X ray scans we can provide a long-term solution for missing or failing teeth. Using a titanium screw placed directly into your jaw bone which acts as the tooth root, we can then permanently and securely fix a new porcelain tooth/teeth onto this. These teeth are always a similar size shape and colour to the rest of your teeth. We also offer All on 4: teeth in a day. We can replace your failing teeth with implants and a fixed bridge on the same day.

Smile makeovers – Is literally creating a new smile. When teeth are worn, discoloured, misshapen, we can replace these with new crowns/veneers giving you an instant perfect smile. At Forma all our dental crowns are made from porcelain for longevity, some of our smile makeovers have lasted over 30 years. We can give you your perfect smiles in just 3 appointments; consultation, preparation and final fit.

Forma Beauty – Offering a wide range of anti wrinkle treatments. Dermal fillers to create volume and vitalise the skin and cryotherapy services to rejuvenate the skin.

3. Central London location

Our London practice is situated in the heart of the city at 65 London Wall, very near to Liverpool Street Station, easily accessible via public transport.

All our treatments are personal and tailor-made, we offer a one-to-one consultation at the surgery but are available for any queries by phone or email. We want to make sure your treatment is easy and that you always feel help is never far away.

4. Thousands of happy patients

Forma has been established for over 30 years; within that time we have created thousands of new smiles. Our aim is to turn your frowns into smiles. We want to see beautiful, straight teeth behind confident, healthy smiles. Check out our website for before & after photos and patient reviews.

 5. Evening and weekend appointments

Here at Forma we understand that life sometimes just gets in the way. So, we want to make it easier for you make your appointments/checkups so therefore we offer evenings and Saturday appointments.

6. Interest free payment plan options

Once we have met you at our initial consultation, we will go through your treatment options and the different ways to pay.  We offer interest free payment plans if you would like to spread the cost of your treatment.

7. Removable retainers

Once you have completed your treatment with Invisalign, we want to make sure your new perfect smile stays in place. We offer you 3 sets of Invisalign Vivera clear retainers which will last up to 10 years, for you to wear at night.

8. Free teeth whitening.

Once you have finished your treatment, we give you complimentary Philips Zoom teeth whitening, which you will do in the comfort of your home. This adds the finishing touches to your new perfect smile.

FormaSmile

O post 8 Reasons to choose FormaSmile. apareceu primeiro em Forma Smile | Dentist in London - Dental Clinic London - Invisalign Clinic in London - Invisalign Specialist - Dental Implants in London - Dental Care - Dental Boutique based in Central London EC2.

Original Coke, original sin?

The PH or acidity of a fizzy drink can dissolve enamel and dentine.

Fizzy drink acid levels are usually below the neutral Ph of 7. At a ph of 7 there is no dissolution or movement of ions.

Critical ph is that ph at which enamel dissolves in the oral environment, which is roughly 5.5.

As you can see many fizzy drinks are at an acidic level well below that.

Sipping Coke or Pepsi over a prolonged period can cause acid attack and microscopic enamel attack.

Most drinks also contain sugar, and so the oral bacteria can digest these sugars, producing acids as by products and cause further dissolution.

Acid attack with drinks is different from chewing sweets or chocolates.

Chewing usually causes decay on the posterior teeth, whereas drinking sugary, fizzy drinks usually causes upper anterior decay (the lower teeth are protected by the tongue when swallowing).

Acid attack is most notorious when a patient sips and holds the drink in the mouth for a few seconds, when patients have fixed braces on or drinking withInvisalign aligners in.

Case presentation

This interesting case is an 18 year old male who used to drink Coke every day. He rarely brushed his teeth during his teenage angst days and slowly developed dark cavities.

He was a shy fellow and was embarrassed by the cavities and he would not go to the dentist. Eventually when it dawned on him that he may want to go to University, he plucked up the courage to come to the clinic with his mother and ask what could be done to beautify him.

Dietary analysis was undertaken and it was recommended that fizzy drinks should stop immediately. A sodium fluoride mouth rinse was recommended.

It can be seen that the upper teeth edges have become translucent from acid erosion. The uppers and lowers had numerous deep cavities.

We decided to excavate the soft caries and place glass ionomer fillings to arrest the caries.

The lower teeth had composite fillings placed in 1 visit.

We agreed that the upper teeth should receive porcelain veneers, but the patient wanted to keep his lucky midline diastema.

Over a period of 2 weeks we transformed this young man’s smile and placed 6 porcelain veneers.

He was quietly happy and never looked back.

He has a great job and those veneers are still there 20 years later.

Nowadays we use Emax or zirconium porcelain veneers.

Both materials have differing properties and must be used when indicated for individual situations.

Veneers can last more than 20 years. Sometimes overbrushing can cause gum shrinkage that exposes the veneer edges and some patients then want the veneers replaced.

#veneers#emax#zirconium#smiel#smile makeover

O post Fizzy drinks and tooth erosion part 2 apareceu primeiro em Forma Smile | Dentist in London - Dental Clinic London - Invisalign Clinic in London - Invisalign Specialist - Dental Implants in London - Dental Care - Dental Boutique based in Central London EC2.

There is a new trend of Seltzer drinks, Seltzer water and even Seltzer alcoholic drinks; they all contain Carbon Dioxide.

Unfortunately dissolved carbon dioxide creates a weak acid called carbonic acid.

Acids can dissolve minerals such as enamel and dentine and are in the long term harmful to the teeth.

Enamel is 95% mineral and Dentine is 70% mineral. Both contain crystals of Hydroxyapatite and some fluoride atoms as well.

Acids react with minerals to cause the release of ions and the minerals effectively start to dissolve.

As many sip fizzy drinks from cans, the acid attack is ferquent throughout the day and the enamel slowly starts to dissolve.

Initially the teeth may looks shiny or have translucent edges, but eventually you start developing pits and cavities as above.

Most composite repairs will begin to stain or wear away, especially if one continues drinking fizzy drinks. In the case above the gentleman was 26 years old and had for many years been replacing the anterior fillings.

He wanted a better solution and we firstly asked him to drink still water and refrain from all fizzy drinks. A diet analysis was also carried out to see if he was eating anything too sweet etc.

After careful analysis we asked him to come back to discuss options.

He did not like the repeat fillings and also thought his teeth were too long or misshapen. We discussed Emax veneers as a better long term option. Veneers are known to lats over 20 years+ if looked after.

A veneer is a cover. It can be bonded onto the front tooth with no or little preparation of the tooth. In some cases we align the teeth with Invisalign firstly to get the best out of the smile, before veneering.

Veneers involve setting up a mock up of the new shape and length and if the patient us happy, we then prepare the teeth gently.

2 weeks later new porcelain Emax veneers were bonded to the teeth. You may notice some pink porcelain at the gum levels; we use this when there has been gum recession and the patient does not want extremely long teeth.

The Emax will not stain as composites do and will rarely chip or fail. The occlusion is always investigated for any irregularities beforehand.

For individual cases we use the harder and more durable Zirconia porcelain; which gives a very white smile.

Acid erosion can lead to damaged teeth and a poor smile, but modern day dentistry if minimal, can also save the teeth and restore confidence.

In the 1920s many film and theatre actors would have silicate or plastic crowns bonded to their teeth. In modern times many celebrities have porcelain veneers instead.

With veneers the smile is whiter, more cosmetic, more aesthetic and extremely confidence boosting. Although not every actor has a great smile; some dentists do not take care when providing treatment and can make their patients look ‘Goofy’.

In the next article we will discuss acid erosion at it’s worst and how we gave confidence back to a patient.

#veneers#smile#smilemakeover#emax#zirconium#hollywood smile

O post Fizzy drinks and tooth erosion part 1 apareceu primeiro em Forma Smile | Dentist in London - Dental Clinic London - Invisalign Clinic in London - Invisalign Specialist - Dental Implants in London - Dental Care - Dental Boutique based in Central London EC2.

Smile makeover case: 10

Instant orthodontics:

Both patients were females in their mid 20s. They had not wanted fixed braces as teenagers and now wanted straight teeth. The problem being that they still did not want braces.

Both patients had overlapping incisors and prominent canines.

We agreed that we could place 6 upper veneers with some moderate preparations.

Upper case was shade B1
Lower case was shade A1; gum lines could not be altered.

Treatment time was 2 weeks including the initial consultation.
Fortress porcelain veneers
Lab Keith Rowe Ltd.

O post Smile makeover case: 10 apareceu primeiro em Forma Smile | Dentist in London - Dental Clinic London - Invisalign Clinic in London - Invisalign Specialist - Dental Implants in London - Dental Care - Dental Boutique based in Central London EC2.

Smile makeover case: 09

This lady was in her 20s. She had been a keen horse rider but had once fallen down and knocked her front tooth.

The tooth had broken, and had been repaired, but this had worn down over time, leaving a shorter UR1.
This tooth had also suffered nerve death and the inside having darkened severely had discoloured the outer enamel.

She really needed orthodontics but was getting married later in the year. Her upper front 4 teeth were sticking out. Both her upper canines were hidden and the front 4 teeth protrusion was quite substantial.

We agreed on 6 upper porcelain veneers with some deep preparation where required. The front 4 incisors were shortened and straightened. The canines were brought out with minimal preparation.

We chose an A1 shade to lighten the smile and to compliment her lower teeth.
The UR1 veneer still had some darkness underneath it, but the patient did not show it on smiling.

Some dentists would have used a more opaque porcelain but then all the other 5 teeth would look very opaque and lifeless.

Patient was very happy

Treatment time was 2 weeks including the initial consultation.
Fortress porcelain veneers
Lab Keith Rowe Ltd.

O post Smile makeover case: 09 apareceu primeiro em Forma Smile | Dentist in London - Dental Clinic London - Invisalign Clinic in London - Invisalign Specialist - Dental Implants in London - Dental Care - Dental Boutique based in Central London EC2.

Smile makeover case: 08

This lady was in her mid 50s. She had 6 upper porcelain crowns placed at different times and she was not happy with her tired smile.

The crowns were very opaque and were made of metal covered in porcelain and were also bulky due to the extra thickness of metal.
They also appeared slightly yellow and again that was due to the metal opaquer layer.

Her upper smile line was also uneven, slanting downwards on her left hand side.
In order to correct the cant we had to shorten the left teeth and lengthen the right side.

I asked her to visit my technician so that they could get a porcelain shade to match the lower teeth.

We agreed to remove the 6 upper crowns, to reduce the bulkiness and replace with metal free porcelain crowns.

We chose an A1 shade to lighten the smile and to compliment her age.

Treatment time was 3 weeks including the initial consultation.
Fortress porcelain crowns
Lab Keith Rowe Ltd.

O post Smile makeover case: 08 apareceu primeiro em Forma Smile | Dentist in London - Dental Clinic London - Invisalign Clinic in London - Invisalign Specialist - Dental Implants in London - Dental Care - Dental Boutique based in Central London EC2.