Full Mouth Reconstruction Improves Patient Bite and Enhances Smile

When Patrick came to Adler Cosmetic & Family Dentistry he was concerned about his bite being off and how his smile looked.  He wanted straight natural looking teeth but didn’t want the hassle of wearing braces as an adult.  Patrick was over closed meaning that his upper teeth covered his lower teeth when his teeth were together.  He also had a limited opening and was aware that he clenched and ground his teeth.  He had been told in the past that he would need jaw surgery in order to get his bite corrected.  Patrick wanted to correct these issues without having major surgery.

Note Patrick's Deep Bite

Dr. Adler noted in his exam that although Patrick was not having a severe amount of jaw pain, that his bite did need to be corrected.  His teeth showed distinctive wear patterns and were crowded.  The alignment of his teeth and his midline was off center.  His deep bite also concerned Dr. Adler because that indicated muscle fatigue and an incorrect bite.  Dr. Adler recommended a K7 evaluation in order determine exactly what Patrick’s muscles were doing and the best way to correct his bite issues. 

The K7 evaluation consisted of running a series of test using non-invasive computerized electronic instrumentation.  It began with taking diagnostic cast so we have an accurate model of his mouth and bite.  The K7 produces scans that measure the muscles, range of motion, and joint noise among other things.  EMG or electromyography measures the muscles at rest and during function-clench.  CMS (computerized mandibular scan) measures joint function, habitual freeway space, swallowing, and range of motion. Sonography measures joint sounds.  TENS or Transcutaneous Neural Stimulation relaxes the muscles in the face and neck to find their true resting state and establish the occlusion at that position.  Material is then placed in the patient’s mouth to capture that ideal position, known as the bite registration or myobite.  Patrick’s scans showed improvement when preformed with the bite in place.  Based upon the information gathered during the K7 evaluation, it was determined that the best course of treatment would be for Patrick to be fitted with a fixed orthotic that would be bonded to his lower teeth would reposition his bite and jaw into its ideal position.  Dr. Adler recommended that once Patrick’s bite had settled into the proper position to then do a full mouth reconstruction where all of his teeth would be crowned to rebuild his bite into the correct place permanently without the continued use of an orthotic.

Patrick After

The bite registration was used by the laboratory to fabricate the fixed orthotic that was bonded to his lower teeth to establish that ideal position.  The orthotic was worn and adjusted for several months and gave Patrick a good trial run for how his bite would feel after permanent restoration was completed.

Patrick's Great Smile After

Once Dr. Adler was confident that Patrick’s bite was in its ideal position, phase II began in which his entire mouth was reconstructed into its new bite.  In just one visit, all of Patrick’s teeth were prepared for his crowns and the orthotic was removed.  Temporary crown that matched the shape and size of the new permanent teeth were fitted over the prepared teeth until the permanent ones were completed.  Impressions of Patrick’s ideal bite, including the bite registration, were sent to Aurum Ceramic Laboratories for use in the fabrication of the final crowns.  Each crown was custom made into Patrick’s ideal bite so that an orthotic would no longer be necessary.  During fabrication the lab also took aesthetics into account so the crowns were made to be the most aesthetically appealing for the patient’s individual smile.  Once the lab had completed fabrication, Patrick had all the permanent crowns placed in just one visit. The final results were amazing.  Not only does Patrick have a great looking smile but now his bite is also corrected and without the need for surgery.

Tags: boulder, Colorado, cosmetic dentist, Cosmetic Dentistry, full mouth reconstruction

Full Mouth Reconstruction Creates Beautiful New Smile

 

 

 

 

Richard

Richard originally came to Adler Cosmetic & Family Dentistry because he was unhappy with his smile.  He was concerned that his bite had been changing over the years including changing color, crowding, and problems with his gums.  He wanted to keep his teeth and gums healthy and get an updated smile.  He had spent a lot of time in the dental chair at other offices just fixing one tooth at time without getting the overall results that he wanted.  At the time Dr. Adler had recently begun studying at the Las Vegas Instituted (LVI) expanding his knowledge of both cosmetic and neuromuscular dentistry.  Instead of just evaluating Richard’s problems as individual teeth to be fixed independently, he looked at Richard’s mouth as a whole and addressed all the issues together.  Dr. Adler realized that the training he had received at LVI was just the solution that Richard was looking for.

Richard Before

The first step to a healthy smile is healthy gums.  Richard had periodontal disease, a chronic bacterial infection that affects the gums and the bone supporting the teeth.  If left untreated, a serious infection can lead to bone loss and tooth loss.  To treat his periodontal disease, Richard had scaling and root planning done.  During this procedure, the hygienist, Susan, numbed quadrants of Richard’s mouth, since the gum tissue was inflamed and sensitive, and then scaled out the bacteria and calculus (tartar) that had built up under the gum tissue.  After the procedure, Richard had to make sure to get his regular cleanings done every three months (as opposed to the usual recommendation of every 6 months) in order to maintain healthy gums and manage his periodontal disease.

Once Richard’s gums were healthy, then Dr. Adler focused on his bite problems.  A K7 evaluation was performed to determine exactly what was happening with Richard’s bite and the best way to approach fixing the problem.  The K7 evaluation consisted of running a series of test using non-invasive computerized electronic instrumentation.  It began with taking diagnostic cast so we have an accurate model of his mouth and bite.  The K7 produces scans that measure the muscles, range of motion, and joint noise among other things.  EMG or electromyography measures the muscles at rest and during function-clench. CMS (computerized mandibular scan) measures joint function, habitual freeway space, swallowing, and range of motion.  Sonography measures joint sounds.  TENS or Transcutaneous Neural Stimulation relaxes the muscles in the face and neck to find their true resting state and establish the occlusion at that position.  Material is then placed in the patient’s mouth to capture that ideal position, known as the bite registration.  Based upon the information gather during the K7 evaluation, it was determined that the best course of treatment would be for Richard to be fitted with a fixed orthotic that would be bonded to his lower teeth that would reposition his bite and jaw into its ideal position.  Once his bite had settled into the proper position to then do a full mouth reconstruction where all of his teeth would be crowned to rebuild his bite into the correct place permanently without the continued use of an orthotic.

Richard is Smiling Now!

 

 

 

Richard After

Richard, who was Dr. Adler’s first full mouth reconstruction case, met Dr. Adler and his assistants in Las Vegas at the Las Vegas Institution to do the final restorations under the guidance of LVI’s highly trained instructors.  During the first procedure, the fixed lower orthotic was removed and all of Richard’s teeth were prepared for the crowns.  Temporary crowns were then placed while the impressions were sent to Aurum Ceramic Dental Laboratory where Richard’s crowns would be custom fabricated into his new bite and better looking smile.  Once fabrication on the crowns was complete, Richard returned to LVI with Dr. Adler to have the case seated.  The temporary crowns were removed and Richard’s amazing new crowns were cemented into his ideal bite with strong clear cement.  Now Richard is smiling all the time and is proud to show off his teeth.

Tags: boulder, Colorado, cosmetic dentist, Cosmetic Dentistry, full mouth reconstruction