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ASSC/Center for Advance Dental Studies. Treatment Planning Case – December 4, 2012. Patient. 39 year old female Concerned about – Missing teeth Spaced out lower teeth Dissatisfied with upper removable partial Poor retention Clicks when in function Dissatisfied with “flatness of mid-face”.

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assc center for advance dental studies
ASSC/Center for Advance Dental Studies
  • Treatment Planning Case – December 4, 2012
patient
Patient
  • 39 year old female
  • Concerned about –
    • Missing teeth
    • Spaced out lower teeth
    • Dissatisfied with upper removable partial
      • Poor retention
      • Clicks when in function
    • Dissatisfied with “flatness of mid-face”
medical history
Medical History
  • No Significant Medical History
  • Not On Any Medications
  • No Allergies
diagnosis
Diagnosis
  • Dental
    • Missing teeth #’s 2,4-14,16,19,30,32
    • Caries #’s 18,29,31
    • Overhanging restorations 3, 15,20
    • Generalized mild marginal bone loss 1 – 2mm
    • Apical periodontitis # 29
    • Inadequate / Failing restorations
      • Teeth #’s 1,3,15,20, 31
diagnosis1
Diagnosis
  • Skeletal
    • Maxillary hypoplasia A/P, Transverse, Vertical
    • Severe resorption of maxillary alveolus
    • Enlarged maxillary sinuses
treatment planning exercises
Treatment Planning Exercises
  • Assume that there is no financial restrictions
  • From a removable prosthetic standpoint what are the problems and restrictions that this patient presents? How would one best design a removable partial or full denture with this skeletal relationship without using implants?
    • What are the limitations?
    • What is the long term prognosis?
treatment planning exercises1
Treatment Planning Exercises
  • How can dental implants be used in this patient to facilitate a partial denture?
  • How can implants be used to facilitate a removable full denture?
  • How can implants be used to develop a full fixed restoration?
treatment planning exercises2
Treatment Planning Exercises
  • What are the limits and restrictions that the patient has regarding her present dentition and skeletal relationship that limits or prevents the previous treatment modalities?
  • Can these relationships be managed to allow for a workable, stable prosthetic solution, establishing acceptable occlusal and functional relationship?
  • How?
acknowledgement
Acknowledgement
  • I understand that this is a very complex case, and the actual treatment of it is not so important (although we will review it)
  • What I am looking for in our discussion is to develop understandings on how we deal with a challenging skeletal relationship and the thought process in removal prosthetic design as well as utilization of modalities such as implants if possible to facilitate a stable result.
teams
Teams
  • We will divide the group in to three teams to discuss these options. Again, regardless of the option, there are no monetary or medical restrictions.