Comprehensive Occlusal Reconstruction by Dr. Alla Brown

73-year-old patient for the past 15 years. Over time, the patient has developed occlusal disease, leading to significant wear and deterioration of her teeth.

The patient presented with a failing bridge on the upper right side, teeth #3-5. Upon examination, both teeth were determined to be hopeless and required extraction, followed by implant placement. Given the severity of the occlusal disease and the long-term benefits of a comprehensive approach, determined to proceed with full occlusal reconstruction.

To begin the process, Dr. Zatopek fitted the patient with a quick splint for two weeks, allowing for the evaluation of her new bite. After confirming that the patient was adapting well, Dr. Zatopek collected the centric relation (CR) bite and other essential records, which were then sent to Gold Dust for detailed analysis and fabrication.

Preparation and Mock-Up

During the preparation appointment prepped the upper 6 and lower 10 teeth. A mock-up was performed, giving the patient a visual representation of the expected results and ensuring her comfort with the proposed changes.

Screw-retained provisional bridges were then placed on the upper posterior implants, set at the new vertical dimension of occlusion (VDO). This step was vital in establishing the new occlusal scheme and allowing the patient to adjust before proceeding with the final restorations.

Final Restoration

Once the patient had successfully adapted to the provisional bridges at the new VDO  the final restorations were placed on the upper 6 and lower 10 teeth, designed to harmonize with the new occlusal scheme and enhance the patient’s smile. Following this fabricated and placed the upper screw-retained fixed partial dentures (FPDs) on the implants and completed the treatment with a crown on tooth #30.

Outcome

This comprehensive approach not only addressed the immediate concerns with the failing bridge but also provided a long-term solution to the patient’s occlusal disease. The patient now enjoys a stable, comfortable bite, significantly reduced risk of future dental breakdown, and an aesthetically pleasing smile.

Case by CMS Faculty Dr. Alla Brown