Name: PowerPoint Presentation
Uploaded: 2022-06-09
Duration: 3 min 7 s
Description: Interdisciplinary Treatment Of An Adult With A Debilitated Dentition.

Interdisciplinary Treatment Of An Adult With A Debilitated Dentition. 

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Interdisciplinary Treatment Of An Adult With A Debilitated Dentition

Occasionally orthodontists will be challenged to treat adult patients who not only have a malocclusion, but also have a myriad of other dental problems that complicate the plan for the orthodontist. These patients require interdisciplinary treatment often involving periodontal therapy, jaw surgery, endodontic therapy, and restorative dentistry in addition to the orthodontics. The following case will illustrate how a team can manage these types of multidisciplinary problems.. 

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Occasionally orthodontists will be challenged to treat adult patients who not only have a malocclusion, but also have a myriad of other dental problems that complicate the plan for the orthodontist.  These patients require interdisciplinary treatment often involving periodontal therapy, jaw surgery, endodontic therapy, and restorative dentistry in addition to the orthodontics.  The following case will illustrate how a team can manage these types of multidisciplinary problems.

Powers01. Powers02. Powers03. Background Information. 

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34 years 8 months of age Doesn’t want to lose her teeth Medical history is noncontributory Recently treated by a periodontist No temporomandibular joint symptoms Cost of treatment is not a problem

Powers05. Powers07. Powers09. Periodontal Status. 

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Moderate periodontitis Now seeing periodontist routinely Significant anterior bone loss Guarded prognosis lower incisors Gingival grafting in lower anterior Class III furca lower left first molar Moderate anterior tooth mobilities

Powers04. Powers06. Powers08. Powers10. Powers11. 

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Powers12. Powers14. Powers15. Radiographic Findings. 

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Significant anterior bone loss Guarded prognosis lower incisors Class III furca lower left first molar No endodontic problems Supereruption lower left premolar

Powers06. Powers05. Powers16. Treatment Objectives. 

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Align the teeth Improve periodontal health Reduce anterior overbite Reduce anterior overjet Facilitate future restorations Improve facial profile Establish good interdigitation

Powers06. Powers05. Powers16. Treatment Alternatives. 

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Non extraction approach.  Align both arches, close part of the upper 	spaces to reduce the overjet.  Place two implants on the left side and 	one implant on the right side.  Restore remaining teeth as necessary. Extract mandibular right and left first premolars, close lower and  	upper extraction sites and leave space for a single-tooth implant in  	the maxillary left canine region. Extract mandibular central incisors and close the mandibular space 	orthodontically.  Then perform maxillary posterior segmental surgery 	to close the maxillary posterior spaces from the distal and a sagittal 	split osteotomy to lengthen the mandible.  Restore the maxillary arch 	with a conventional fixed prosthesis to replace the missing canine.

Powers04. Powers21. Pretreatment. Posttreatment. Treatment Results. 

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Powers24. Powers08. Powers23. Powers06. Pretreatment. 

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Powers10. Powers11. Powers25. Powers26. Pretreatment. 

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Powers22. Powers14. Powers15. Powers33. Pretreatment. 

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PowersS36. PowersS38. Pretreatment/Preoperative. Preoperative/Posttreatment. 

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Powers19. Powers20. Powers01. Powers02. Pretreatment. 

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Powers34. Powers05. PowersS40. Conclusions. This patient was treated with a combined approach of orthodontics, jaw surgery, periodontal maintenance, and eventual restorative dentistry. The extraction of her mandibular central incisors was instrumental at eliminating two hopeless teeth and allowing her to maintain her natural mandibular teeth.. 

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This patient was treated with a combined approach of orthodontics, jaw surgery, periodontal maintenance, and eventual restorative dentistry.  The extraction of  her mandibular central incisors was  instrumental at eliminating two hopeless teeth and allowing her to maintain her  natural mandibular teeth.

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