FP-3 Case 19 · Reconstruction · Implants

Finishing What Two Continents Could Not

Her implants were already in. Nobody could finish the case.

She came to Dr. Reshad referred by her surgeon in San Diego. The implants had been placed; finishing the treatment had proved difficult.

She was wearing partial dentures and provisional restorations that were uncomfortable, at the end of a long journey across two continents in search of treatment. The more dentistry she received, the worse her condition seemed to get.

None of the doctors she had seen could give her a clear path to completion. She arrived hoping that a prosthodontist could.

Before and after

Before

After

Arrival

A collapsed bite that moved in unusual ways

She required almost a full mouth reconstruction. Her bite was collapsed, and the real challenge was that her occlusion was unconventional: her jaws moved into very unusual positions, fracturing provisional restorations and causing a great deal of jaw pain.

That complication is what a prosthodontist's training in bite and jaw-joint dysfunction is for. Dr. Reshad found an occlusal scheme that stabilized the unusual jaw movements and relieved the pain she had lived with for years.

At arrival

Retracted

Radiograph

The finished work

Upper and lower

Upper

Lower

The plan

Three to four months, despite the presentation

After a thorough consultation, followed by a detailed treatment and conference appointment, she was ready to start. Treatment was completed in three to four months.

With CAD-CAM, every detail of the occlusion worked out in the provisionals is copied into the final restorations. Every aspect of the treatment is tested first in provisionals identical to the finals, so that when the finals are delivered the patient is already comfortable with them.