Full Arch Transitional Bonding

21 Rating(s).


Posted on By Jeffrey Sims In Composite Resin

Patient had not had dental treatment in years and entered my practice with serverly worn teeth, unrestorable molars, severe decay and need of periodontal scaling. Initial treatment consisted of extraction of unrestorable teeth with bone grafting for future posterior implants, deep scaling of entire mouth, couple rootcanals then wax up to determine future incised edges and overall occlusion.

Patient choose not to seek orthodontic treatment. Diagnostic wax up was completed, putty stent for maxillary anteriors fabricated and upper and lower full arch impressions of wax up made with a clear material enabling composite to be loaded and cured thru impression.

Maxillary anteriors restored first with putty stent, then posterior uppers, then every other lower tooth, then the rest of the lower teeth utilizing a clear impression to load and cure composite. Tokuyama composite utilized on maxillary 6 anteriors then Z250 Filtek for the rest of the teeth.

Pre op Full Face
Pre op Smile

Pre op Retracted
Post op Retracted


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2 Comments

Nice result Jeff. Ron Goldstein would be proud. Did you do DSD, or wax up....mock up?
Will we see you in February at #XP Global Symposium in Florida?? Regards Mo


Reply

Hi Mo,
Thanks for your kind comments.
I did not utilize DSD or a direct mock up but fabricated my own wax up. I needed to open his bite to gain room for restorative material, so do to time constraints of the patient, my schedule and the need for stable occlusal contacts, it had to be all or nothing on the same day. Since his treatment plan involves extractions, socket preservation, endo, perio, implants and veneers, this patient needed to phase his treatment for financial reasons.
It made sense to do transitional resins to give him aesthetic improvement and stable occlusal contacts once the unrestorable teeth were removed, periodontal scalings completed and caries removed.
I did utilize a clear impression material called Crystal from Clinicians Choice to copy the diagnostic wax up. I then placed composite in every other tooth, inserted, then cured the composite thru the Crystal material. Removed the form, made sure the contacts were open adjusted as needed, then did the remaining teeth.
An all day procedure this past December 15.

Pre op Max arch
Post op composite build up


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