Butterflies in the Stomach
I just saw this full mouth rehab that I did more than ten years ago for a follow up. I don’t know about you guys but I always get butterflies in the stomach when I see these patients on the schedule….
Once a year, I get to evaluate my own work to see if they are still holding up. This one happens to be holding up quite nicely. But there are some cases that didn’t hold up and it hurts to see failures.
I can always criticize my own work looking back to say that I could have done this better or done that better. And sometimes I beat myself over these failures. And so for now, I just want to share some things I have learned from my own journey when doing these reconstructive cases
1/I like Class I cases. I don’t like Class II and III cases. I can’t develop ideal occlusal relationship unless I can correct the skeletal discrepancy.
2/I start with a preliminary prosthetic treatment plan. But I don’t commit to a final prosthetic design until I can see how the patient destroys my temporary restorations. Seeing how the patient destroys my temporary restorations allows me to see the type of forces that are present so I can design my prosthetic treatment to counteract or to re-organize the forces.
3/Splinting teeth can be a good prosthetic strategy to protect teeth. We were taught in dental school connecting teeth like a bridge is a bad thing….if one abutment fails, then the whole thing needs to be redone. But to me, splinting teeth allows me to protect the weak abutment ….it also allows me to share the occlusal forces as well.
4/Understanding occlusion is key. I am still amazed at how things can hold up when you understand the meanings of stable posterior occlusion and favourable anterior guidance.
5/Ultimately despite my best efforts, some of my treatment may fail…but I hope to have provided a solution that would have slowed down this process.
I hope you find these pearls useful in your own learning journey. Thanks for reading
