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6 eaed
This document summarizes the treatment plan for a 61-year old male patient seeking improvement of the esthetics of his upper front teeth. The patient has a medical condition of thrombosis and is on anticoagulant medication. An examination found excessive gum display when smiling, short upper front teeth, and wear from parafunction. The proposed treatment plan is to create provisional restorations to test aesthetics, function, and phonetics. Final ceramic restorations will then be made using the provisionals as a guide. The goals are to satisfy aesthetic concerns, restore stable occlusion, and develop a long-term strategy to protect the remaining teeth from further wear.
6 eaed
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- 2. Patient 6 *male * 61 years * medical condition: - thrombosis - medication: anti-coangulant * patient’s request: - Improvement of the esthetics of the teeth in the upper jaw ! - natural looking but color little bit brighter
- 3. Facial Analysis DigitalFacebow
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- 5. Facial Analysis excessiveanterior gingival display anterior gummy smile
- 6. extra-oral examination *horizontal and vertical reference lines: ! - with in normal limits - facial = dental midline (1/2 mm to the right) ! * in the anterior maxilla extended soft-tissue display
- 7. Facial Analysis Lipsin Repose +/- 3 mm tooth structure
- 8. Facial Analysis FullSmile Lip Dynamics WNL
- 9. Facial Analysis FullSmile Anterior Gummy Smile
- 10. Dental Analysis 8mm 9 mm envelope of function??
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- 13. Dental Analysis Function no tender muscles, no joint problems
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- 15. Dental Analysis Function Central incisors retroclined
- 16. composite restoration metalceramic crown intra-oral examination:
- 17. C e n t r i c R e l a t i o n intra-oral examination/study cast: cro = mip possibility to open the envelope of function
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- 21. anterior gummy smiledue to dental alveolar eruption af anterior teeth short anterior teeth (12-22) constricted envelope of function due to loss of anatomical form of teeth / parafunction (airway issue?) recessions due to abrasion recessions due to abrasion diagnosis
- 22. what are thepatient’s financial constraints? for now treatment limited to the upper jaw how could we satisfy the patient’s aesthetic and functional concerns? how to create better length/width ratio’s on the upper anterior teeth should we add to the incisal edges to lengthen the anterior teeth? If so should we open the vdo? Is the patient willing to go through orthodontic treatment, periodontal surgery or to manage teeth restoratively? how to manage the amount of wear? can we restore this patient predictably with long-term strategy? primary concerns
- 23. protect remaining teethfrom wear/ open envelope op function restore a stable occlusion in centric related occlusion with anterior guidance provisional restoration phase of 3 months to check, biology, function and aesthetics satisfy aesthetic concerns develop long term-strategy treatment objectives
- 24. replace old compositesfor new ones adjust occlusion to create cro = mip prep teeth (backwards planning) and restore with provisional restorations to try out aesthetics adjustments, function and phonetics re-evaluate provisionals copy provisionals to ceramic restorations night guard maintenance program treatment plan
- 25. functional/aesthetic wax-up incentric relation
- 26. functional/aesthetic wax-up incentric relation
- 27. wax-up used fora preparation guide
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- 29. provisional restorations (chairside made)
- 30. test aesthetics, function,phonetics with the provisional restorations (chair side made)
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