A Simple Solution to a Complex Problem
by Nicholas Miller, DMD, MS, FACP, Board Certified Prosthodontist | Georgia Prosthodontics
Rebecca, a 29-year-old female, was unhappy with the way she looked and the way her mouth and teeth functioned. Ten years ago, Rebecca had teeth removed in the maxillary left region as the result of an odontogenic cyst. To fix this, she would need bone grafts and implants.
Treatment to Removable Partial Denture included
After collecting diagnostic information and consult with ENT (ENT was consulted due to involvement of cyst with maxillary sinus), the patient was presented with several treatment options:
• Consult with OMFS for bone graft with donor site possible from tibia or floating rib in preparation for placement of dental implants for fixed prosthesis
• Combination of block graft and orthodontics. A block graft would be completed prior to orthodontics then tooth #14 would be moved into occlusal plane.
After orthodontics re-evaluation would be needed for the need for more block graft prior to implants at sites #11, 12.
• Fixed partial denture #10-14 with gingival replacement
• Removable partial denture to replace teeth #11, 12.
• Do nothing.
After evaluating the treatment options Rebecca chose the least invasive option, a removable partial denture, to replace missing teeth #11, 12 and prosthetically align #14.
The classic sequence of treatment was followed to fabricate the RPD:
• Preliminary impressions and analysis with surveyor
• Tooth preparations including rest preps #2, 3, 15 and guide planes #14, 10
• Fabrication of metal RPD framework with mesh in edentulous area and over tooth #14
• Milled PMMA teeth #11, 12, 14
• Try-in of framework with teeth to evaluate esthetics and occlusion
• Process RPD using Ivobase system
• Delivery of prosthesis to patient.
When treatment planning complex prosthodontic cases it is very important to give the patient all the treatment options and sequence. This specific case has non-invasive and short time commitment treatment options to invasive and long time commitment options.
It is important that the patient knows all the options so they know how a treatment decision now could affect treatment options in the future.
Treatment Outcome
Rebecca underwent a procedure to create a partial denture and is very happy with the results. She is pleased with the way she looks and has adapted well to the new device. She can now smile, speak and eat comfortably.
If you have comments or questions about Rebecca’s case, please email me at: smileagain@gaprostho.com
As a Prosthodontist, I often coordinate with a patient’s general dentist and other dental specialists that they’ve seen.
If you have a patient in a similar situation and would like to team up for either the surgical or surgical and restorative planning of a similar case we would be happy to assist you.
How can a Certified Prosthodontist assist you and your dental team?
We specialize in the treatment of complex cases, usually involving several procedures over months of care. The next time you see a challenging case, please feel free to call us and we can discuss treatment planning or help you with any part of the treatment. Our goal is to be a resource for your office by helping manage difficult and time-consuming procedures, restoring the function and esthetics that each patient desires, then referring them back to your office for their ongoing care.
If you have a patient with several missing, broken, or severely worn teeth they may be a candidate for oral rehabilitation with the assistance of a Prosthodontist.
Study Club In Prosthodontics
New Findings & Best Practices for Cosmetic & Restorative Dentistry
Do you want another opinion on a complex case? Or to meet and share ideas?
There are many ways we can help each other by working together on complex cases and by sharing knowledge and experience.
With your reputation for quality dental care and our experience with restorative treatments, we can work together on advanced cases and both benefit!
If you’d like to meet to discuss a difficult procedure or talk on the phone about how we can help each other, please call or email our office with specific days and times when you are available to talk or meet.
Registration for future events visit us at STUDY CLUB
The Reconstructive Dentistry Team
Georgia Prosthodontics is focused on Implant, Cosmetic, and Reconstructive Dentistry. Drs. Carlos Castro, Dr. Nicholas Miller, and Dr. Brian Brodine have the training and private practice experience that makes treatments of complex cases more successful, including patients:
• With severely worn/damaged teeth, missing all teeth, or with ill-fitting dentures can receive a full arch of natural-looking teeth to restore function & esthetics.
• Congenital defects, a chronic condition, or traumatic injury can receive oral prostheses, which may be a combination of dental implants, crowns, bridges, or veneers.
• Patients with difficult anterior cases in the esthetic zone can receive single or multiple dental implants to replace missing teeth, or veneers or crowns to improve the appearance of their smile.
In addition, they have a private dental laboratory called Prostho Dental Lab. An in-house, experienced, and certified dental technician creates each custom restoration for referred patients from the best materials using the latest technology. To send an implant case to our dental lab, please visit: www.prostholab.com
Online Referral Form
Dear Doctor:
We appreciate your confidence in us. To refer one of your patients to a Prosthodontist you can either download our referral form or fill it out online and send it directly to us.
We look forward to hearing from you!