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ePaper created 2017-09-22, 22:09:32 | version 1.38.0
digital_3-D technology Fig. 9 Fig. 10 Fig. 11 communicating the extent of my patients’ condi- tions and the comprehensive nature as to what is necessary to return them to a full complement of teeth and oral health. Patients unaware of the de- struction caused by bacterial infection, poor den- tistry and neglect are very difficult to convince that they require extensive dental treatment to improve their oral health. Since I have the benefit of 3-D im- aging, their conditions can be displayed on a large computer screen, which facilitates an interactive conversation which generally results in their under- standing their problems and moving forward with the necessary treatment presented. It is especially useful when evaluating bone deficiencies, periapi- cal pathology, evaluating existing periodontal sup- port and residual bone volume in edentulous areas. All of the following cases benefited via advanced 3-D imaging to gain a complete understanding of the enormity of the obstacles these patients faced prior to commencing with treatment. The case presenta- tion visit explained clearly how advanced implant dentistry and proper sequencing would provide each patient with their desired result. The goal for each was to rehabilitate these patients with an aesthetic and fully functioning maxillary arch of new teeth. They all were given options to replace hopeless max- illary arches with the guarantee being that their prosthetic replacements would look and function much better than their failing natural dentition. What follows is how I diagnosed, treatment planned, case presented and treated three decimated maxil- lary arches. As you read my applications of the 3-D difference and the eventual treatments, think about how these cases were positively impacted by the use of 3-D imaging and how its use led to case accep- tance and facilitated positive patient experiences, even though these cases were as complex and chal- lenging as exist in the dentistry today. Where do we begin? All three patients presented with a common prob- lem, hopeless maxillary dentitions due to years of neglect, fear and poor maintenance of their natural dentitions. These types of situations are complex and challenging to treat. Each case required the re- moval of all maxillary natural teeth, but psycholog- ical complexities made for the unique treatment plans developed. It took a lot of courage for these patients to finally decide that they were ready to proceed with a treatment to improve their condi- tions. The decimated dentition requires managing the whole patient and the 3-D difference increases the ability for my patients to understand and accept treatment. My office has a distinct advantage over offices lacking the technology. The first patient accepted her fate of an immediate complete upper denture, prior to guided implant placement and replacing her teeth with an implant retained metal reinforced horseshoe CUD overden- ture. The second patient was not ready to accept the immediate complete upper denture so she would be transitioned into a four unit implant retained re- Fig. 12a Fig. 12b 44 3_2017 44 digital