Full Mouth Reconstruction Improves Patient Bite and Enhances Smile

Patrick's Smile Before
Patrick’s Smile Before

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

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

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

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.


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