Behind every full mouth reconstruction that I planned and treated with a patient is a story that only the patient and I can understand. As a prosthodontist, I don’t always have the luxury of a built in trust or rapport with the patient that a general dentist may have with their patients for many years. Their first encounter with me is usually one of confusion, uncertainty of why his/her dentist had referred to me. One of my biggest challenges is to evaluate the patient, often with incomplete information, and to develop a tentative treatment plan and then to explain to a patient what this may involve during our first meeting. Like any relationship, it takes both the dentist and the patient willing to work together to develop a treatment plan that is catered to the patient’s needs.
This patient would have been 96 this year. I treated her few years ago and at the time she must have been in her late 80s. As you can see, she has inadequate posterior support, bite collapse and severe overjet and overbite. Her remaining mandibular teeth were all worn down. Aside from that, they were quite strong periodontally. But to keep these teeth and to provide her with adequate function and aesthetics would have required so many appointments and procedures that I don’t think will be the right treatment plan.
Instead, I decided to remove her remaining bottom teeth and placed six implants to provide a fixed solution for her bottom teeth. Her top teeth are not perfect, but with her deteriorating back who cannot tolerate long appointments, I provided her a conservative cast RPD for posterior support. When I completed her treatment, I remembered her telling me that she can eat anything now with no problem. To me, that is the biggest compliment I can ask for.
I hope you find this post helpful. Thanks for reading!
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