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Before and After 2016: Smile Makeover – Full Mouth Reconstruction with a Heart-warming Testimonial

A female patient in her 50s was referred to me for a consultation, who literally got ‘hit by a bus’ in an accident. Multiple facial reconstruction and surgeries had been performed, yet she was dissatisfied with the dental work provided.


After a lengthy discussion with the patient and the treating clinician, we decided to restore her brand-new smile with confidence by performing a full-mouth reconstruction. There were existing implant restorations from 12-22 – the right lateral incisor to the left lateral incisor, replaced in Screwed-Retained Implant bridge. The rest to be done in lithium disilicate (e.max).


Fig 1 shows the pre-op condition. The patient’s lower lip was still hanging down at this point (due to the trauma), and thus she showed more of her lower teeth than the upper.


She hoped to achieve a brighter smile with natural aesthetics and a fair amount of translucency and characteristics. In her words, she was after the best possible outcome that she could receive in Australia. Her primary shade was A2 initially (Fig 2), but wanted to go somewhere around BL4 as a base in the Bleach Shade Guide (Ivoclar Vivadent).


We decided to treat this case at stages:

  1. Upper six anterior (front) teeth
  2. Upper posterior (back) teeth
  3. Lower posterior (back) teeth
  4. Lower anterior (front) teeth


Figs 3-5 show the first stage of the treatment, from the designing stage to the completed restorations of upper six anterior teeth on the model. Colour matching in different materials was challenging between zirconia and lithium disilicate, but I was happy with the way it came out.


Figs 6 &7 show the final stage of the treatment – working on lower anterior teeth. Note the shade of the upper is close to BL4, which the patient desired.


The lower central incisors were prepped slightly more than the rest, to gain some additional thickness in the restoration for slight masking, preventing the darkness showing through from the stump.


Figs 8-11 show the completed restorations; a five-year follow-up. It was so lovely to catch up with the patient and witness how well she was recovering from the accident. She looks stunning, doesn’t she (and 20 years younger than her actual age)? It is hard to believe that her face was utterly disfigured at some point.


The patient permitted to share something personal here. Fig 12 shows a heart-warming letter I received from her back in 2016, which I’ve kept as my treasure.


It is not every day that I receive a thankyou letter from the patients; no matter how good the outcomes are from my perspective. Although all the patients I treat are happy, most don’t go the extra mile to send me a testimonial unless necessary. Being appreciated in this way is why I do what I do – to help people love their smiles. It gives me motivation and assurance that what I do is valuable for others. It gives me a sense of worth in that I can contribute to society!


The letter reads:


“Dear Yugo,


Hello, it is some time since I last saw you as a patient. I initially had my first consult with you about 10 years ago, after a rather unfortunate accident with a bus and myself – whilst crossing Oxford Street, near Centennial Park, after exercising in the grounds. My name is Julie – you probably don’t remember me, but I sure remember you and your wonderful craftsmanship.


On my initial visit, I remember your beautiful Jack Russell putty, and of course you – your sincerity, care, interest and genuine dedication to your work.


I write this, because I want you to know how much you have changed my life and accelerated my rehabilitation.


Before I saw you, I had undergone many many procedures & operations to improve my facial disfigurements as well as my head injury, a multiple fractures.


Without your excellent knowledge and workmanship as an “elite” technician I would still not be smiling!


But thankyou to you, Yugo, I now can “smile”(with confidence) and some asymmetry (that’s my fault) around my mouth & right side of my face.


Am so pleased and very proud of my “new teeth” and all because I was so lucky to have been referred to you and your wonderful practice.


Words really don’t express enough how I feel, and how you have given me such confidence!


Last time, or the last consult, you were studying for your exams and I don’t know how you survive – on such little sleep, and such a long extensive workload.


Your ambition and drive to excel is very commendable and “quite extraordinary” – I am confident you will do very well in the years to come.


I am a very lucky patient, to have been introduced to you, and I am very appreciative of your care and excellent skills. Good luck with your final exams, and please give my regards to “Chris” – your very diligent P.A.


I cannot speak highly enough of you Yugo, and will always refer your expertise to anyone needing specialised, excellent dental prosthetics etc.


I am sure, I will keep in touch, I am very much honoured to have been treated by you and your practice.


Wishing you the very best for your future,


Yours Sincerely,

Julie Hastie X


September 2016 “




I’d like to thank Dr Duncan Copp from The Paddington Dental Surgery in Paddington NSW, Australia, for his clinical excellence.


This case was issued at four different stages, as shown above, and completed in January 2016.




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