Dr Ridhwaan Haffajee

17/11/2025

👨🏽‍🎨Anterior Aesthetics With Cutback Zirconia🎨

Rehabilitation of teeth 11 and 21 was completed using monolithic zirconia with facial cutback, allowing for controlled ceramic layering to optimise translucency, value, and surface morphology. This hybrid approach provides the flexural strength of zirconia while re-introducing the optical properties required for the aesthetic zone.

Evidence continues to support zirconia as a reliable anterior material when handled with proper design, adhesive protocols, and veneering strategies. Facial cutback reduces the volume of veneering ceramic and therefore the risk of chipping, while still achieving polychromatic depth and enamel-like characterisation (Sailer et al., 2018; Zhang & Lawn, 2018).

Key to note that to have a cutback design (and stump blockout) with layering ceramic does require a more aggressive preparation to allow for the volume of material needed.

The final outcome demonstrates how material selection, stump shade control, and soft-tissue stability collectively influence aesthetic predictability in high-visibility restorations.

📚 References:
– Sailer I, et al. (2018). All-ceramic or metal–ceramic tooth-supported fixed dental prostheses? J Dent, 72: 7–13.
– Zhang Y, Lawn BR. (2018). Novel zirconia materials in dentistry. J Dent Res, 97(2): 140–147.
– ITI Consensus (2018). Prosthodontic materials and optical considerations in the aesthetic zone.

# crowns

13/11/2025

Removable dentures have evolved far beyond the “gap fillers” of the past.
Modern acrylic-based prostheses, when fabricated with premium teeth and high-performance denture base resins, now offer exceptional aesthetics, strength, and comfort.

Today’s removable dentures incorporate natural tooth morphology — lifelike texture, translucency, surface anatomy, and individualised colour layering — allowing outcomes that closely mimic natural dentition. For many patients, this means a prosthesis that looks and feels far more natural than earlier generations.

When combined with dental implants, retention and stability are significantly improved. This translates into enhanced function, confidence, and better nutritional intake, particularly important as patients age and overall systemic health becomes more dependent on efficient mastication.

Modern materials + thoughtful design + implant support = predictable comfort, improved chewing efficiency, and a more confident smile.

References
• Bidra, A.S. et al. (2019) Contemporary materials and concepts for removable prosthodontics. J Prosthet Dent, 121(3), pp. 474–482.
• Zoidis, P. (2021) Acrylic resin advances for removable prostheses. Int J Prosthodont, 34(5), pp. 579–587.
• Feine, J.S. et al. (2002) The McGill Consensus on overdentures: functional and nutritional benefits. J Prosthet Dent, 88(1), pp. 28–34.
• Emami, E. et al. (2013) Masticatory performance and nutritional status in older adults with implant overdentures. Clin Oral Impl Res, 24(5), pp. 557–563.

06/11/2025

05/11/2025

Case selection matters🕵🏼

Not every patient is a candidate for a fixed, immediate-load solution.

Age, dexterity, and the ability to maintain hygiene play crucial roles in long-term success. Removable implant-supported prostheses often offer a safer, more maintainable alternative—especially when approached with sound clinical reasoning rather than enthusiasm for immediacy.

Careful diagnosis, not convenience, should guide our choice🥊

(Malo et al., 2012; Feine et al., 2018)

27/08/2025

⏳2 YEAR FOLLOW UP⌛️
Before and afters are cool - cut some enamel, impression (maybe a digital scan) and throw on some ceramic ?
What separates this from the truely rewarding cases is the meticulous planning, the intense collaboration between surgery, prosthodontics and ceramist, the symphony between materials, science and biology as healing occurs and culminates in long term stability.
Marginal integrity of restorations is critical in supporting periodontal health and ensuring efficient plaque control.
📝The approach to every patient should be minimal treatment based on education on long term consequences of any treatment plan - not just the immediate gratification that follows. ‘Aesthetic rehabilitations’ will fail at some point regardless of how ‘good’ the before and after are.
🎨Non surgical endodontic therapy was initially carried out and sealed Totalfill BC (FKG ), gingival recontouring and surgery with long term provisional restorations before replacing with Lithium Dislicate with micro-veneering ( )

22/08/2025

🦷 Monolithic vs. Veneered Zirconia in Full-Arch Implant Prostheses
When it comes to restoring full arches, zirconia offers a compelling combination of strength, esthetics, and biocompatibility. But which option stands the test of time—monolithic or veneered?

💪 Monolithic Zirconia
✔️ ~900–1200 MPa flexural strength
✔️ Excellent fracture resistance
✔️ Minimal chipping—ideal for bruxers
✔️ Superior long-term predictability (Pjetursson et al., 2022)

💎 Veneered Zirconia
✔️ Enhanced esthetics for anterior zones
❗️Higher risk of chipping at the veneer interface
❗️Often bulkier to accommodate porcelain layering

📊 The Evidence?
Clinical data consistently shows lower complication rates and greater durability with monolithic zirconia, particularly in high-stress full-arch cases (Bidra et al., 2021; Stawarczyk et al., 2023). Veneering is now largely reserved for selective esthetic refinement only.

📸 In this case, we opted for a full-arch monolithic zirconia prosthesis—prioritizing strength, function, and longevity.

👉 The Verdict:
For most full-arch implant cases, monolithic zirconia delivers reliability without compromise.

20/08/2025

🦷
Dental implant made easy?

Its videos like these that we often find on our feed and sometimes comes across as “dental implants are easy to restore. I take an impression and the lab does the rest”
The sad reality is that this is the furthest from reality. A culmination of meticulous diagnostics, treatment planning, implant planning (type and position),soft tissue assessment, loading protocol… and and and…
I firmly advise any young dentist to invest in sound education - not a single day “weekend” crash course on impression taking - engage with a mentor or network or mentors and dental implantology can eventually become ‘routine’
To the patients - IT IS YOUR RIGHT TO ASK YOUR TREATING PRACTITIONER WHAT TRAINING DO THEY HAVE TO TREAT YOU.

19/08/2025

🧲All-on-4 & A–P Spread🧲

Defining the Limits
In full-arch implant rehabilitation using the All-on-4 protocol, a critical biomechanical factor is the anteroposterior (A–P) spread—the distance from the anterior implants (often at the lateral incisor position) to the distal aspect of the posterior tilted implants (typically in the first molar region) (Maló et al., 2020).

✅Why A–P Spread Matters:
This distance determines how much cantilever your prosthesis can safely support.
🔹 Ideal A–P spread: 10–12 mm minimum
🔹 Safe cantilever limit: No more than 1.5× the A–P spread, although a 1:1 ratio is often more predictable and biomechanically conservative (Agliardi et al., 2021).

✅Enhancing A–P Spread:
> Tilt posterior implants 30°–45° to reach the first molar zone while avoiding anatomical structures.

> Use surgical guides and CBCT planning to optimise implant distribution and ensure clean access for hygiene.
Avoid overextending cantilevers, which increase stress on distal abutments and prosthetic components (Bevilacqua et al., 2022).

📸 This case shows posterior angulation, enhancing A–P spread for a balanced and cleansable full-arch prosthesis with minimal cantilever.

18/08/2025

Replacing terminal dentition with full-arch implants is never a simple switch — it’s a comprehensive transition, both surgically and prosthetically. But when done correctly, it offers life-changing function, esthetics, and stability.
Terminal dentition is often the result of advanced periodontitis, non-restorable caries, or repeated prosthetic failure. And while the All-on-4 protocol remains a classic, many cases benefit from 5–6 implants per arch — optimizing biomechanics and long-term success.
Strategic implant angulation is key: it allows us to avoid critical anatomy, improve screw access, reduce cantilever stress, and increase primary stability — especially in compromised ridges. Ultimately, full-arch rehabilitation is about much more than just replacing teeth — it’s about rethinking the entire foundation.

15/08/2025

Where to begin? Which arch is the real problem? Implant therapy requires us to look beyond the obvious — because successful outcomes depend on seeing the full picture.
Implant treatment is tertiary-level care. That means compromise has little to no place in the planning process. Evidence-based, textbook protocols should always guide the path forward.
In this case, while the maxillary partial denture was the initial concern, a comprehensive occlusal analysis revealed severe over-eruption of the mandibular anterior teeth. True stability came only after first restoring the mandibular arch, followed by implant reconstruction in the maxilla — in a staged, functional sequence.

13/08/2025

Check out the full setup required for a full-arch implant rehabilitation 👇
Alginate - CBCT- IOS - Articulators - Smile designs - impression copings - analogues - Ti bases— every tool plays a role in delivering precision, predictability, and long-term success.
Full-arch restorations aren’t just about placing implants. They’re about planning, collaboration, and using the right equipment to restore a full smile with confidence.

12/08/2025

Not all “Before and After” cases leave us satisfied — not because the outcome isn’t successful, but because the treatment could have been avoided.
Tooth surface loss is too often acknowledged but left untreated. Without early intervention, the consequences can be significant — sometimes leading to full-mouth reconstructions involving extractions and implants.
Early diagnosis allows for conservative, minimally invasive, and cost-effective treatment options: education, splint therapy, and resin bonding. While implant rehabilitation is predictable and safe, it should never be a substitute for natural teeth where preservation is possible.
Prevention remains the priority.