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ePaper created 2016-09-09, 12:12:48 | version 1.38.0
2_2016 20 case report _ digital planning Digital planning for full mouth reconstruction Author_dr. ara Nazarian, USa _With greater public awareness about cosmetic dental reconstructions, dentists are often challenged with greater demands from the patient. This increased demand for aesthetic re- storative treatment challenges the dentist, the laboratory technician and dental manufacturers to develop techniques and materials to satisfy the discerning patient. Utilising digital planning, modern materials and effective techniques, the restorative team can succeed in restoring a smile to proper form, function, and health. The case presented in this article demonstrates the sig- nificance of a systematic approach to planning, preparation and material selection in full mouth reconstruction of a patient’s dentition. _Case presentation A man in his late 30s was referred to my practice by his dental provider because he was dissatisfied with the appearance of his smile. The patient commented that he felt that his exist- ing teeth and restorations were unattractive be- cause of recurrent decay, wear and colour (Figs. 1 & 2). Most importantly, he mentioned that he was suffering from tension headaches, grinding and a limited range of function. Initial diagnostic evaluation at the first ap- pointment consisted of a series of digital images with study casts, a centric relation bite record, a face bow transfer and a full mouth set of X-rays. In the maxillary arch, the patient had several teeth that had worn composite restorations as well as abfractions with cervical decay. Tooth #5 had an existing crown on an implant. In the low- er arch, several existing composite restorations had wear as well as decay on the facial cervical areas. Although there were no restorations pres- ent in the anterior mandibular teeth, there was severe wear in the incisal edges due to possible grinding, parafunction and end-to-end bite. _Planning After reviewing the clinical findings as well as the mounted models, the patient was diag- nosed with a restricted envelope of function and decreased vertical dimension from continuous wear. To develop a treatment plan and determine if the vertical dimension could be increased, a di- agnostic 3-D White Wax-Up (Arrowhead Dental Lab) was fabricated (Fig. 3). With this service, the dental provider also receives a Preparation Guide as well as a Temporisation Fabrication Template Fig. 1_Preoperative retracted view biting. Fig. 2_Preoperative retracted view open. Fig. 1 Fig. 2