Dr. Simone Gorini | DT Giovanni Faccin
Rehabilitation with table tops and palatal veeners
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Daniele, 30 Y Old, with the chief compliant that “my palatal teeth were deteriorating and I would like to do something”.
Clinically have a deep bite and a several erosion of palatal surfaces of upper incisors. The TMJ is in good health and the opening of the mouth is in physiological range. In dynamic movements, protrusive, laterality right and left are very steep.
The purpose of treatment is to preserve dental surfaces in the upper palatal teeth, increasing VDO (vertical dimension occlusion) in the posterior teeth of the mandible with Table tops and palatal veeners from 13 to 23. For the clinical study two alginate impression were taken and the casts articulated in MIP (maximum intercuspidation), using a face bow. The wax up was build up on the posterior teeth of the mandible. An arbitrary increase of the VDO was decided and silicon key was prepared from this waxed up casts. The patient was scheduled for the mandibular mock-up and for three weeks the frontal teeth didn’t have a contact in MIP to allow the mandible to find a comfortable position.
During this period the patient have tolerated very well the new position and have found a better comfort during chewing and muscles too. Finally we have prepared the surfaces of posterior teeth for accomodate table tops and the palatal surfaces for six veeners. The impression was realized in polyninyl siloxane. The laboratory technician received the maxillary and mandibular impression. Thanks to the posterior JIG he mounted the two casts in MIP. Six table Tops in Disilicate of Litium (34 35 36 44 45 46) and two in Composite (37 47) were fabricated.
Six palatal veeners in Composite completed the work of dental technician.
After two weeks, in one appointment of six hours, 8 table tops and six palatal veeners were bonded, one at time, using rubber dam.
The teeth wereThe control after 1 months shows a good integration in estetics and a better comfort in dynamic movements of the mastication.
Often the patient frequent a Gym and he told us that felt more strength during yours exercise with weights, attributing a relationship with the work made.
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