Jonathon’s case is very unusual. Growing up he did not have access to a lot of dental treatment. He is a young patient in his 20’s, and his main concern was that he was getting married and he only had a very short period of time in which to get treatment done.
In Jonathon’s case he is missing his lateral teeth and his front canines have moved into the position where these were supposed to be. He has some baby teeth that needed to come out and also has teeth missing from the back as well as a collapsed bite. When patients have this many issues, you are generally looking at braces and/or surgery. Most of the time people seek out an orthodontic consultant so they can move the teeth into a better position. With Jaw surgery, the time it takes to plan and do the surgery is 2-3 years. Because Jonathon only had 6 months before the wedding, one of the other options was to look at porcelain treatment.
One of the most important things to consider when doing porcelain treatment is that the porcelain will only last between 10-20 years, so you have to choose your patients carefully. It is important that patients understand this and that they will require more attention in the future.
In Jonathon’s case we used jaw repositioning treatment where we used a computer to calculate a more perfect bite. This is also known as neuromuscular dentistry. At ADAP we don’t tend up use that term very much, but in this case we have to balance the position of the teeth with the jaw joint and the jaw muscles making sure the bite is in the right position. This is very important because physiologically speaking you want everything to be in harmony and balance.
The ideal bite is a balance between the teeth and the position of the teeth, and the position of the muscles and position if the jaw joints. From there what we have done is to test the bite. We have done 2 things to achieve this; first we have given a trial smile which is to trial the cosmetics, and secondly we have given him a trial bite. Obviously, this went on top of the original teeth, we did not alter his teeth at all. We put the trial bite in, allowed it to stabilise over a 2/3 month period, then we completed the bite and cosmetics at the same time.
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