A Simplified Approach to Full Mouth Rehab (Completed Full Mouth Restoration in Bonded Resin)

65 Rating(s).


Posted on By Gerald Benjamin In Full Arch & Dentures

The wax up is transferred to the mouth using sectional putty matrix's.
This is NOT a finely done resin artistic case. That said, the patient usually loves the appearance of their smile. A resin shade is selected, C3 in this case, to lengthen the teeth. This is NOT the shade of the completed case but it does encourage the patient to complete the case in porcelain.

This technique is challenging because of the time involved but there is absolutely NO Stress because all of the requirements of a full mouth rehab have been previously established.

Soft tissue sculpting does not take place at this appointment.

The patient loves his new smile and I saw him today for minor occlusal adjustments. He has been scheduled to complete treatment.

Yes there was a separate fee for the resin bonding

Full Smile in bonded resin
Retracted anterior view post bonding

Established plane of occlusion lateral view
Occlusal view of completed bonded resin


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7 Comments

Gerald what a great service for the patient.
Do you have any pre-op photos?
Hope all is well Brian Mills


Reply

Hi Brian;
The pre op in a separate post which was posted the same time.[ A Simplified Approach to Full Mouth Rehab (Pre Op)]
This is not like the YOUTUBE videos that you posted where the completed case is resin.
I use this technique to evaluate VD, CR, speech and esthetics prior to proceeding to a full mouth rehab in porcelain. This allows the patient, if they so desire, to do a section of the mouth at a time for financial reasons. This patient will go directly to porcelain in a few weeks.
Regards,
gerald


Reply

Look forward to seeing the final result. Take care Brian


Reply

Gerald, Great explanation. Could you please explain how you evaluate VD. Is it evaluated by pt. perception, muscle tonicity or a combination of things? Thank you again.


Reply

Hi Terry;
Great question!!!And this is the BEST and least stressful part of the entire technique.
Dental schools made us fearful of 'opening the patient too much" or not getting the perfect CR (or whatever.)
Rule of thumb...the joint WANTS to seat unless something prevents it from doing so...usually posterior teeth.

1. Mock up the maxillary anterior teeth. If the teeth are worn to the cingulum then you must mock up the cingulum as well..If you start with a 7.5 mm central. Add 3 mm to the incisal edge and create a cingulum that is approximately the right shape (cure)...ie the lower tooth has to hit against something.Mockup at least 4-6 teeth (Note: The 'average' central is 10.5-11 mm)
2. Check the Fricative (F) sounds
3. If the the mandibular anterior teeth are 5 mm in length and they need to be 8-9 mm in height. Add 3.5 mm to the incisal edges of all teeth..cure (no bonding technique)
4. Have the patient count from 1-10 and then 50-60.
5. Wait 10-15 minutes and continue to speak to your patient until you are sure that speech is correct.
6. Ask the patient to gently close on what would be their back teeth then look at the posterior segment and you will see a 3-4 mm opening between the max and mand molars.
7. Ask you patient to gently close as if they were biting on their back teeth. The joint HAS seated.
8. Inject bite registration material into the posterior open space.

You have found the absolute correct VD and CR with no stress or worry.
*If speech is not clear...shorten the max anterior teeth slightly for 'F' sounds...if the 66 sound is too slushy, add to the incisal edges of the mandibular teeth.

This is right out of the denture course.
Best regards,
gerald


Reply

Thank you Gerald, Tomorrow I will post a case of extreme wear I am considering treating. I would so much appreciate your opinion and guidance.


Reply

Hi Terry;
My pleasure.
Most dentists are reasonably proficient at dentures but become very fearful when approaching a full mouth rehab. These cases are truly stress free because I treat it like a denture case and then convert it to a routine C & B case..No CR issues and no vertical issues because that has all been worked out.
And you don't have to do your own wax ups BUT....IF you have the lab wax up the case, they have to wax the max/mand 6 teeth ONLY and fabricate a Siltex matrix using the UNTOUCHED POSTERIOR (and the linguals of the teeth)as your stop. They can make another matrix for the posterior segment or you can just do resin blobs.

The lab must know that their wax up just replaces the missing (worn) part of the tooth and on your build up appt, that is what you are replacing except where esthetics is critical and you may have to go over the facial.
Geraldben1@gmail.com or cell if you want it.


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