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Adjunct Professor School of Clinical Dentistry

Ronald G. Presswood. Adjunct Professor School of Clinical Dentistry. Lorraine S. Five years of pain and obsession. Three restorative events, numerous splints. Asked us to make a splint after almost a year of observation. Previous Splints, Five Years. Current Max Anterior RP.

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Adjunct Professor School of Clinical Dentistry

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  1. Ronald G. Presswood Adjunct Professor School of Clinical Dentistry

  2. Lorraine S. Five years of pain and obsession. Three restorative events, numerous splints. Asked us to make a splint after almost a year of observation.

  3. Previous Splints, Five Years Current Max Anterior RP. Teeth do not fit together .

  4. Failed Restorations, UR Crowns required Extensive Adjustment. Often Came Uncemented

  5. Initial Seat, PGA, Pain R Which contacts stimulate pain on the right?

  6. 1st Adj, much better, 11/8/05 Why? This guide supports R TMJ.

  7. Resurface Posterior, 11/15/05 One week after initial placement. Why do you think this was done? Add the balancing guide!

  8. Resurface Posterior, 11/15/05 What did we gain?

  9. 1st Adjustment, 11/15/05

  10. 3rd Adjustment, 11/15/05 Anything wrong on the splint?

  11. 4th, Final Adjustment, 11/15/05

  12. Initial Check, Sore R, 11/21/05 Why is she sore on the right? Could it be an Anterior Guide Issue?

  13. 1st Adjustment, OK, 11/21/05 Done Yet? NO!!! What’s the issue?

  14. 2nd, Final Adjustment, 11/21/05 Are you looking at the ink, or the streak.

  15. Initial mark, #4 “soft”, 11/28/05 Upper Bi is tender to percussion and 1+ mobile. How did we get this marking?? Why did we want it?

  16. 2nd mark, #4 better, 11/28/05 Anything else get your Attention?

  17. 3rd mark, all ok (OK?), 11/28/05 Is this splint OK for patient to leave? What about 10, UL 2 and 12, UL 4?

  18. Initial mark, Pain R, 11/30/05 Pain on right keeps coming back. What do you think is changing? Could a muscle be releasing? Why are the markings so small? Or, could a joint be healing? Inflammation going away?

  19. Almost complete, one last thing Slight discom- fort on right. What do you think is causing the problem? What you think about having only 2nd molar contacts?

  20. Initial Mark, Feels Good, 12/5/05 Light Tap = MIP

  21. 3rd Adj., R click, 12/5/05 Why is there a right click? What marks are involved? What instru- ment is used to remove the contact?

  22. 3rd Adj., No click, 12/5/05 So, which contacts did we remove?

  23. Which Tooth Contacts Are Bad? Which contacts, in which order?

  24. Which Tooth Contacts Are Bad? Which contacts, in which order? Relieved on maxillary teeth Balancing Guides

  25. Noxious Guide on Bicuspid

  26. Balancing Guides Are Protective Balancing guide maintains mutual contact. Working guide progressively isolates inclines and “rocks” the teeth. Balancing Guides All the same radius

  27. OA to soften the guide

  28. Muscle Pain R #2, 12/15/05 What’s the Issue?

  29. 5th, final, adjustment, 12/15/05 Any bad Contacts? What are these?

  30. Initial Mark, Feels Good, 3/1/06 From Dec. 15 until March 1, she was seen weekly. MUSCLE AND JOINT HAVE NOT BEEN A MAJOR ISSUE SINCE JANUARY. Any unhealthy contacts?

  31. Initial Mark, Feels Good, 3/1/06 Same Marks, Different Perspective. Where are the bad ones?

  32. Use of personal photographs Dear Dr. Presswood, Yes, you have my permission to display the two photos taken of me while under your care. I wish you continued good work with your clinical studies, which I hope will be able to help more people- just like you have helped me. Because of you and your care, I now have a better quality of life. Sincerely, Lorraine S 6 November 2009

  33. Pre and Post Photos, 6 Months 12/2006 05/2007

  34. Attending Doctors • Neurologist • Internist • Physical Therapist • DDS, PhD, Pain Specialist • Ron Presswood, General Dentist Who is doing the better job from the patients perspective? Why do you think that?

  35. Dear Dr. Presswood, I hope that your summer is progressing well and that you and yours are doing fine! I am writing to tell you that in six years time, I am having the best summer since 2001!!!!! I have reduced my Gabapentin by 100 mg. to a total of 800 mg. daily.  I have had some "bad days", but nothing compared to the past.  I wear my splint 24/7 and only take it out to eat.  I can tell that my  "bite" is not firm or sound, but while wearing the splint........... it is solid. My muscles seem to have calmed down quite a bit with all of the splint adjustments that you made Nov. -May. This is the first time in six years that I am anxious to return to Houston.  I will call Lisa to make an appt. so you can slowly start to adjust my bite on my real teeth!  I am optimistic that you can help me even more.

  36. I don't know how to begin to thank you.  You have made such a difference in my life -all for the better. George, Abby and I are having a record September for visiting house guests -friends and family.  We love having company visit, since we're gone from Houston so much.  Also, our friends like to get "out of the heat"! I never did actually invite you, but you and your wife are always welcome to come to the mountains and visit us here -(Sept. is "booked"!!!)  Maybe October? Please give Lisa and Julie my best.  I will see you all in November for sure. Sincerely and with heartfelt thanks, Lorraine S., August 31, 2006

  37. Thanks for your attention!! The End of The Beginning !!

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