1) The document discusses the treatment planning and reconstructive prosthetic management of a TMD patient who presented with multiple dental issues including clefts, tooth destruction, loss of lower teeth, and crowding. 2) Treatment included preprosthetic dental therapy, surgery, implantology, temporary prosthetics, and control of jaw relation stability. Jaw models were rearranged and results were checked. 3) Treatment addressed defects of tooth hard tissues, space deficiency, isthmus defects, and involved crown preparation, root canal treatment, microprosthetics, clinical crown lengthening planning, and correction of the gingival margin.

1. Treatment planning and reconstructive prosthetic
management of TMD patient.
Preprosthetic dental therapy, surgery,
implantology, temporary prosthetics, control of
jaw relation stability in TMD patient, jaw models
rearrangement and check-up of the result
Dr. Budovsky Alexander Saint Petersburg

2. Состояние на момент обращения
profile left
oblique
frontal

3. profile rightoblique right

6. Multiple clefts and
erasibility on the
upper frontal dental
bridge - space
deficiency.
Fierce teeth
destruction and
erasibility.
Excessively flattened
cuspids of the crowns

7. Destruction and loss of lower teeth. The areas of
strong teeth erasibility in the front segment

11. Cephalometric analysis. Schwarz craniometrics
analysis

14. The
fragment of
disrupt disc

15. Ricketts analysis

16. Excessive destruction of dental hard tissues, caries relapse

17. Frontal teeth crowding
All frontal crowns are single

18. Defects of teeth hard tissues in a
relation to the pulp chamber
Space deficiency on the palatal surface to create
functional movements
Isthmus defect
The sketchy location of inlay and pin
Comparison of the location in a relation to preparation area, crown axis and upcoming axis
of a future crown

19. The tooth is before preparation to inlay. Crown preparation. After that
root canals are handled with the root bores, largo№ 3 is maximum.
Then sharp and thin margins are cropped and smoothed over.

20. The criteria of interroot area preparation is excision of caries, old restorative
material removal and enough thickness of a tooth sides. Also sharp margins must be
smoothed over

21. Твёрдые ткани зубов сильно поражены и истончены в процессе предыдущего
лечения и кариозного поражения. Наличие микротрещин в дентинеTooth hard tissues are extremely destructed and attenuated after
previous treatment and caries. Microclefts in a dentin

22. Microprosthetics

23. Clinical crown lengthening planning

24. Estimation of gingival margin correction according to post-
resection root length and existence of vestibular cortical bone

25. Dentoalveolar elongation, generalized periodontitis and the area
of upcoming correction

26. Relation between gingival margin and old temporary crowns

30. Finished work in the oral cavity

31. Control occlusion 2 weeks after fixation of crowns
– the testprotocol interference contacts

34. Thank you very much!