“If you fail to plan, you are planning to fail.”
This quote is essential in dentistry. Especially in total rehabilitation. When we deal with one tooth we perform diagnostics mostly concerning one tooth: X-rays, vital check, probing etc. When we perform whole mouth reconstruction we have to find a complete solution for the case. That means we have to make diagnostics for every single tooth but also a functional and aesthetic analysis, occlusion check, temporomandibular joint, alveolar bone and estimations of the patient to make the proper long-term treatment.
This patient came to me with severe tooth attrition and erosion. In my opinion the main cause of it are missing teeth and poor old bridges so she had to masticate using only anterior teeth. So I had to reconstruct her whole dentition to make it function properly
First of all I made an aesthetic analysis. I draw teeth with good proportions which correspond to her face.
Then I asked the dental technician to make a wax model for me so I could check function of my project directly in her mouth. I always use a facebow in such cases to transfer the right position of the jaws.
I haven’t done anything with the teeth yet.
Aesthetically it was good but the bite wasn’t proper. Lower jaw was too forward and the teeth were biting on cusps. So I had to make one more bite registration. If it was ceramics it would be a total fail and new work from the beginning.
After the new model was perfect I prepared the teeth and made definitive ceramic crowns and bridges.
Nice aesthetics and physiological bite means happy patient for many years. With proper planning it’s routine and predicable result in my practice.
UPD. 1 year follow-up