Dr. Yoshinori Kamae
Society Japan Clinical Dentistry Tokyo
(Prosthodontic,Periodontic,Orthodontic,Endodontic)
Dt.Ken Takahashi R.D.T
Case:
She is 47years old. Her chief complain is to make over her smile without fixed bridge.
Diagnostic findings
- Extraoral and facial findings
Concave facial profile
deficient lower facial height
retrognathic mandible with deficient chin
- TMJ and mandibular range of motion
R: Temporo mandibular Antero displacement without reduction
L: Temporo mandibular Antero-lateral displacement with reduction
- Intraoral findings
Dental
Caries tooth
Exaggerated curve of Spee
Exaggerated curve of Wilson
Arch length deficiencies with crowding
Dental arch are somewhat constricted
Class2 malocclusion
Periodontal
Generalized mild to moderate gingival inflammations
Bleeding on probing
Disproportionate levels of marginal gingiva
- Occlusal notes
Class2 relationship
Horizontal overlap (overjet): 6mm
Congenital missing teeth: #42
Missing teeth:#11, #21
Centric relation is not coincide MIP
- Radiographic findings
Incomplete root canal treatment:#13,#12,#22,#23,
Caries; #26,#46
Diagnosis
Class2 malocclusion
Goal/objectives of treatment
Face
Improve facial balance/profile
Increase lower facial height
Smile
Improve appearance of teeth with respect to shape, size, color, and position
Balance levels of maxillary marginal gingiva
Improve alignment of the teeth
Dentition
Balance levels of maxillary and mandibular marginal gingiva
Establish normal morphology of clinical crowns with appropriate dimensions
Establish adequate tooth length to facilitate retention of restorations and resistance to displacement
Eliminate caries lesions
Correct malocclusion of teeth and associated dental and skeletal findings
Align teeth and correct rotations
Establish Class1 relationship, at least anteriorly
Establish optimal horizontal and vertical overlap of teeth
Level occlusal and incisal planes
Establish symmetric dental arch
Eliminate arch length deficiencies and associated crowding of teeth
Establish appropriate spacing for optimal restoration of teeth
Coordinate dental Arches
Restore affected teeth to improve occlusion, function,appearance,stability of tooth position and ability of patient to maintain health and supporting structures
Active Clinical Treatment
Phase Ⅰ: Initial treatment
Phase Ⅱ:Guided bone regeneration
Phase Ⅲ:Orthodontic treatment
Phase Ⅳ:Implant treatment
PhaseⅤ:Definitive restorative treatment
Phase Ⅵ:Maintenance
Acknowledgements
I want to thank the Dr.Masao Yamazaki and Kenji Tsuchiya who advise me management of these patient’s complex dental needs.
And thanks to Mr. Ken Takahashi who always fabricate beautiful restorations.
Finally, I thank Dr.Toyohiko Hidaka to be given me this opportunity .
