Veneers, Crowns, Implants
What to do, how to do it, and when.
Available as a full day or 2 hour synopsis
When a patient comes to your office with a desire to improve his or her smile, where do you begin? Is a veneer case really different from crowns or a full mouth rehabilitation, or one that will require implants? The simple answer is “no.”
All restorative dentistry should be based on the same sequence of analysis and case construction. Every case, no matter how straight forward or complex, demands answers to the same basic questions:
- Where do the teeth go in the face? (the smile line)
- Where do they go in relation to one another? (the occlusion)
- How are they individually shaped? (aesthetics and function)
This program presents a step-by-step blueprint for case analysis and sequencing that can be applied to every case to produce an aesthetic and functional restoration, in a predictable way, every time. Beautiful, natural smiles have many variations, but all conform to the same functional guidelines that allow them to be cosmetic and maintainable over time. All prosthetic cases must follow these same functional guidelines. Rules of function will determine every tooth contour, position, and opposing contact – and the aesthetic result.
Key to this approach is close cooperation between the doctor and the technician.
Guidelines are given that detail what the doctor must send to the laboratory, and what the laboratory’s responsibilities are in return.
Case analysis always starts with the temporomandibular joint. The jaw opens and closes on a hinge axis, the center of which is the joint. Using a face bow and articulator, diagnostic casts can be mounted to accurately reproduce the patient’s jaw position and movement on an instrument outside the mouth. Once this is done, case planning always begins with the upper central incisors. Their shape and position in the face and, specifically, the smile line, is the key to the restoration An occlusal scheme that is simple to learn and construct is presented that determines the placement and interrelationships of cusp tips. By involving the laboratory at the beginning of the treatment process, through the shared analysis of photographs and casts, the technician can create an aesthetic and functional diagnostic wax-up that becomes the blueprint for the case. The wax-up is used to create a provisional that previews the final restoration for both the doctor and the patient, and then becomes the template for the laboratory to fabricate the final restoration. Cases constructed in this way combine both beauty and function.
At the end of the day, you will return to your office with a detailed blueprint for restorative success that you can use right away.
- The Fundamentals of Restorative Dentistry:
- Temporomandibular joint anatomy and function
- Articulators and facebows (theory and practice)
- Occlusal theory
- Occlusal scheme
- Centric holding contacts
- Anterior guidance
- Posterior disclusion
- Centric relation, maximum intercuspation
- Vertical dimension – when to open and when you can’t
- Neutral zone
- Envelope of function
- Jaw muscles
- Anterior deprogrammers
- Bite registrations
- Doctor – Laboratory Communication and Coordination
- Articulator mountings
- Clinical photography
- Doctor mock-ups
- Laboratory diagnostic wax-ups
- Model preparation guides
- Preparation putty indices
- Provisional putty indices
- Case Sequencing
- Case examples – detailed, step by step