The case of a total dental reconstruction with a host of pitfalls and concomitant orofacial probl...
The case of a total dental reconstruction with a host of pitfalls and concomitant orofacial problems.
I wanted to show consecutive decision making in treatment planning. For instance, in therapeutic mouth preparation: removе of tooth pulp or not, how to make the restoration, where is the odontotomy area should be and why? Or how changing of occlusal vertical dimension (VDO) and occlusal plane have an influence on surgical preparation.
There is an important difficulty, which every dentist may encounter in prosthetic patients with such pathology - the TMJ structure instability.
The patient`s TMJ was asymptomatic. And only prior diagnostics showed the disc rupture and inflammation in TMJ.
Moreover, I paid great attention on the methods of jaw relation control and adjustment of occlusion in this presentation.
The fact is that interfering contacts, as we understand it, are absent in total dental reconstruction process. To make my idea clearer, let’s imagine that dental technician, being in his right mind, decided to make a few «upthrust» cuspids to do a bad turn to a dentist. Certainly, it is impossible.
However, those, who have made a lot of total works, know that there may be splits, gum recession, local periodontitis and even fractures of screws, teeth and other problems. It is associated with overload of one area or another.
The absence of harmony between occlusion and TMJ may become a cause of iatrogenic bruxism.
So, where are these interfering contacts from? And how to avoid their appearance or plan the treatment with minimum aftergrowth?
In this case I suggest the methods of control and assessment of occlusal plane and morphology in treatment process and post-prosthetic period.
We must create not only beautiful smile, but healthy. Thus, every dental specialist should consider function of orofacial system and TMJ as well as aesthetics.
I really hope that this information will be helpful for both beginner dentists and experienced specialists.