Case rehab

[Adi]

Hi
A case came to me yesterday , dentist want six attached anterior units upper and lower.
But he wants to increase the bite vertical dimension.
But he was not sure , can we make the prosthesis right now or should we make an adjustable acrylic prosthesis to make sure the patient will adapt to the new increased dimension?

 

[2thm8kr]

Always work these type of things out with the temporary.

 

[dmonwaxa]

Direct, short, concise answer.

 

[Adi]

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[Adi]

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[Contraluz]

That is going to be a lot of work...

Most of the upper anteriors will probably have to come out. Is a periodontist involved in the treatment?

What is desired, fixed? Are implants an option? What can the pt afford?

As mentioned above, diagnostics wax up, provisional etc. And yes, from what can be seen here, you want to increase the vertical dimension. Under normal circumstances, you can increase the VDO quit a bit befor the pt is uncomfortable.

Also, It is important to establish posterior occlusion. This gal ended up like this, in parts, due to missing posterior occlusion.

 

[Adi]

That is going to be a lot of work...

Most of the upper anteriors will probably have to come out. Is a periodontist involved in the treatment?

What is desired, fixed? Are implants an option? What can the pt afford?

As mentioned above, diagnostics wax up, provisional etc. And yes, from what can be seen here, you want to increase the vertical dimension. Under normal circumstances, you can increase the VDO quit a bit befor the pt is uncomfortable.

Also, It is important to establish posterior occlusion. This gal ended up like this, in parts, due to missing posterior occlusion.

Implant is not an option, they want fixed.
Do you think it's a good idea to tract the anteriors palately before preparation?

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[rkm rdt]

I think the dr wants it fixed not fixed.

 

[rkm rdt]

Lack of hygiene = denture.

 

[Contraluz]

Do you think it's a good idea to tract the anteriors palately before preparation?

Oh my... Well, if it is desired to use the teeth visible here in the pictures, to bring them in, ortho would be indicated. What survival rate is predicted, once prepped?? Hygiene doesn't seem to be of priority...

But I really suggest to get posterior occlusial stops!

 

[2thm8kr]

If you increase the vertical dimension when replacing the upper and lower anteriors what are you going to do for the posterior occlusion?

The bone around the upper lateral incisors doesn't look to promising in the x-ray.

 

[rkm rdt]

If you increase the vertical dimension when replacing the upper and lower anteriors what are you going to do for the posterior occlusion?

The bone around the upper lateral incisors doesn't look to promising in the x-ray.

C'mon,those beautiful pfms by Disturbed are holding up just fine.

 

[Adi]

Very well, I got the whole picture now.
Thanks

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[Contraluz]

what are you going to do for the posterior occlusion

And that is part of the original problem. This Pt needs something to chew on in the posterior region. If not, It is bound to fail...

Very well, I got the whole picture now.

This case is not just a 'prep and restore' case. Make sure your client understands that!

 

[Adi]

If you increase the vertical dimension when replacing the upper and lower anteriors what are you going to do for the posterior occlusion?

The bone around the upper lateral incisors doesn't look to promising in the x-ray.

In the posterior an attachment removable.

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