Taking a holistic approach to dentistry to achieve high quality results in complex cases
Complex protocols have to be applied and factors considered with the holistic approach. It can be a major engineering project and has to be managed efficiently both practically and financially with clinical and technical expertise and experience.
Some of the factors considered here may seem strange but it has a profound effect on the final results believe it or not!
This was a complex full mouth reconstruction and rehabilitation case. The patient was mising some teeth and had lost facial height due to the type of bite and both arches has collapsed due to excessive wear over a long period of time. After loosing some of the molar teeth the patient found and felt that what I had been telling himm was coming true and decided to look into it.
Because of the complexity, a digital simulation, mock up smile design and wax-up were made to educate, inform and visualise for the patient what could be done. This was used to show the patient how we record the information we need before starting.
Issues such as
Body and head posture and structural overloads.
Facial symmetry - will it affect the smile line and final outcome?
Is the a skeletal or postural issue and does it have a baring on the bite and jaw position and eventual smile design?
The Clinical Examination includes:
- Malocclusion
- Tooth wear
- Abfractions and Erosion cavities
- Sensitive teeth
- Thorough history of trauma
- Lifestyle
- Excessive wear and bruxism (grinding of teeth)
Acute or chronic facial pain conditions?
TM Joint and earaches and other facial pains?
Headaches with temporal, neck, shoulder and chewing muscle involvements?
Low Level Laser Therapy (LLLT) is used in acute pain management and the results can be noticed within minutes and this just kick starts the healing process. Further treatment may be necessary.
Is the opening and function of mouth involved and painful?
Diagnostics is the THE MOST IMPORTANT PART of the whole treatment protocol.
