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ASSC/Center for Advance Dental Studies

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

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  1. ASSC/Center for Advance Dental Studies • Treatment Planning Case – December 4, 2012

  2. 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”

  3. Medical History • No Significant Medical History • Not On Any Medications • No Allergies

  4. 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

  5. Diagnosis • Skeletal • Maxillary hypoplasia A/P, Transverse, Vertical • Severe resorption of maxillary alveolus • Enlarged maxillary sinuses

  6. 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?

  7. 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?

  8. 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?

  9. 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.

  10. 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.

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