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Author Information

Gregory J. Tarantola, D.D.S. is former Clinical Director of the Department of Education at The Pankey Institute for Advanced Dental Education in Key Biscayne, Florida. In January of 2002, he opened a full time restorative practice and now lives and practices in Jacksonville, Florida. He also continues to lecture around the country and around the world on comprehensive, masticatory system dentistry in a relationship based setting.

Description

Wiley-Blackwell's “Clinical Cases” series is designed to recognize the centrality of clinical cases to the profession by providing actual cases with an academic backbone. Clinical Cases in Restorative and Reconstructive Dentistry describes the principles and demonstrates their practical, every-day application through a range of representative cases building from the simple to the complex and from the common to the rare. This unique approach supports the new trend in case-based and problem-based learning, thoroughly covering topics ranging from infant oral health to complex pulp therapy. Highly illustrated in full color, Clinical Cases in Restorative and Reconstructive Dentistry’s format fosters independent learning and prepares the reader for case-based examinations.

The book presents actual clinical cases, accompanied by academic commentary, that question and educate the reader about essential topics in restorative and reconstructive dentistry. The book begins by laying the groundwork of the fundamental principles that apply to all cases and outlining the ten decisions to be made with all cases. The main sections of the book cover the cases themselves, examining them both by type of restoration / solution, and by type of problem. This unique approach enables the reader to build their skills, aiding the ability to think critically and independently.

Clinical Cases in Restorative and Reconstructive Dentistry’s case-based format is particularly useful for pre-doctoral dental students, post-graduate residents and practitioners, both as a textbook from which to learn about the challenging and absorbing nature of restorative and reconstructive dentistry, and also as a reference tool to help with treatment planning when perplexing cases arise in the dental office.

Table of Contents

Chapter 1 Fundamental principles of the comprehensive, masticatory system approach

Chapter 2 The people side of dentistry

Chapter 3 The 4 essential skills of the comprehensive dentist

• Section A Bite splint therapy
• Section B Definitive occlusal management
• Section C The Diagnostic blueprint
• Section D Provisionals with a purpose

Chapter 4 The 10 decisions

• Section A TMJ diagnosis and condylar position
• Section B Vertical dimension
• Section C Lower incisal edge position
• Section D Upper incisal edge position
• Section E Centric stops
• Section F Anterior guidance
• Section G Curve of spee
• Section H Curve of Wilson
• Section I Cusp-Fossa angle
• Section J The esthetic plane
• Introduction to the case studies

Chapter 5 Non-removable implant restoration with natural teeth

• Case 1 Non-removable maxillary implant restorations with natural teeth restorations including crowns, veneers and fixed partial dentures.
• Case 2 Transitioning a maxillary tooth supported fixed partial denture to an implant supported fixed partial denture along with other single crowns and tooth supported fixed partial dentures.
• Case 3 Lower reconstruction with lower left being implant supported, important neutral zone consideration affecting design. Upper reconstruction landmarks acceptable. Temporomandibular disorder managed.
• Case 4 Maxillary fixed partial denture supported by both teeth and implants along with other implant supported crowns and tooth supported crowns and fixed partial dentures
• Case 5 Maxillary extractions, periodontal surgery, orthodontics, veneers and fixed partial dentures on teeth; mandibular extractions, implants, fixed partial dentures on teeth and implants
• See also: Chapter 6 Case 1
• Chapter 7 Case 7
• Chapter 14 Case 4

Chapter 6 TM disorders followed by reconstruction

• Case 1 Osteoarthritis of the Left TMJ managed with bite splint therapy followed by implant supported restorations and tooth supported restorations
• Case 2 Intracapsular and muscular components of a temporomandibular disorder managed with bite splint therapy followed by occlusal therapy and a full reconstruction
• Case 3 Intracapsular and Muscle disorder resolved with bite splint therapy followed by occlusal reconstruction with maxillary lingual porcelain veneers
• Case 4 Intracapsular and muscle disorder with resultant occlusal plane asymmetry resolved with bite splint therapy and followed by occlusal therapy with restoration only on the lower left
• Case 5 Past condylar replacement due to avascular necrosis followed by posterior occlusal reconstruction
• Case 6 Temporomandibular disorder resolved with bite splint therapy followed by definitive occlusal therapy including a maxillary reconstruction and mandibular functional changes with composite
• Case 7 Past mandibular orthognathic surgery to correct maxillary to mandibular malrelationship caused by condylar degeneration; intracapsular and muscle pain resolved with bite splint therapy followed by definitive occlusal therapy with posterior reconstruction and anterior composites
• See also: Chapter 15 case 1
• Chapter 16 case 1

Chapter 7 Restorations to achieve esthetic and functional changes

• Case 1 Restoration of anterior esthetics and anterior guidance in a deep overbite damaged by bruxism with upper and lower anterior reconstruction
• Case 2 Posterior reconstruction with severe interferences to the centric arc of closure
• Case 3 Restoration of esthetics and anterior guidance damaged by wear by increasing overbite with upper and lower anterior crowns
• Case 4 Maxillary reconstruction at open vertical dimension to improve esthetics, length, buccal profiles and functional landmarks; mandibular restorations only recontoured
• Case 5 Maxillary and mandibular esthetic and functional reconstruction with lab-processed composite restorations to treat amelogenesis imperfect
• Case 6 Restorations maxillary bicuspid to bicuspid done first as part of a comprehensive plan; maxillary left central incisor implant, other functional discrepancies corrected with reshaping and equilibration
• Case 7 Maxillary and mandibular dental reconstruction including 4 dental implants replacing unrestorable teeth. Impaired esthetics due to recession handled with grafts and all porcelain restorations
• See also: Chapter 16 case 1

Chapter 8 Complete implant supported restorations

• Case 1 Complete implant supported maxillary reconstruction – transitioning the anterior teeth from tooth supported to implant supported
• Case 2 Complete maxillary non-removable restoration supported by 6 implants converted from a completed removable restoration on 4 implants
• Case 3 Complete implant supported non-removable maxillary and mandibular reconstructions; transitioning from natural teeth that were not predictably restorable
• Case 4 Maxillary extractions, immediate implant placement, immediate loading and complete non-removable Zirconia restoration with pink porcelain
• Case 5 Mandibular implant bar supported full removable denture converted to a non-removable restoration to improve comfort of the neutral zone and phonetics

Chapter 9 Orthognathics

• Case 1 Severe anterior open bite corrected with maxillary only orthognathics and occlusal therapy with upper incisor restorations
• Case 2 Mandibular orthognathic surgery and chin implant; managing a temporomandibular disorder during treatment; posterior restorative dentistry including implants
• Case 3 Maxillary and mandibular orthognathic surgery with chin advancement; pre-restorative occlusal therapy with equilibration and composite additions
• See also: Chapter 16 Case 1

Chapter 10 Bruxism and wear reconstruction

• Case 1 Restoration of worn lower anterior teeth in a deep bite without changing other restorations
• Case 2 Severe wear from parafunctional habits restored with a complete reconstruction at an increased vertical dimension of occlusion
• See also: Chapter 16 Case 2

Chapter 11 Perio-prosthesis

• Case 1 Full maxillary periodontal-restorative reconstruction improving esthetics and function; lower posterior reconstruction following conventional surgery, bone and soft tissue grafts, covering recession.
• Case 2 Posterior reconstruction in conjunction with conventional periodontal surgery; root resection, pocket elimination.

Chapter 12 Implants in the esthetic zone

• Case 1 Hopeless maxillary central incisor transitioned to an implant supported restoration (delayed placement and delayed loading) with crowns on the remaining incisors along with occlusal therapy
• Case 2 Extraction and immediate implant placement, delayed loading and restoration maxillary central incisors; pink porcelain to simulate papilla
• Case 3 Congenitally missing maxillary lateral incisors, orthodontics to open lateral incisor space, dental implants and other esthetic improvements
• Case 4 Congenitally missing upper right cuspid, upper right lateral incisor lost in an accident. Implant placed in cuspid position with 2-unit cantilever restoration, pink porcelain to simulate gingival
• Case 5 Maxillary central incisor extracted and replaced with a dental implant, delayed placement and delayed loading
• See also Chapter 7 case 6

Chapter 13 Removable implant supported restoration with natural teeth

• Case 1 Maxillary implant supported bar retained removable partial denture along with tooth supported restorations to reconstruct occlusion and vertical dimension
• Case 2 Combination mandibular fixed anterior-removable posterior reconstruction with Locator attachments
• See also: Chapter 14 Case 4

Chapter 14 Combination fixed-removable restoration on natural teeth

• Case 1 Maxillary bar supported removable partial denture; lower crowns with semi-precision removable partial denture.
• Case 2 Maxillary fixed partial dentures with precision removable partial denture; mandibular bar supported complete denture.
• Case 3 Maxillary telescope case: alumina copings on natural teeth and removable overstructure; mandibular telescope case: Galvano copings on natural teeth and non-removable overstructures
• Case 4 Mandibular anterior fixed partial denture and posterior removable partial denture with implants and Locator attachments for added support and retention; maxillary reconstruction, telescope case with one dental implant included along with six teeth.

Chapter 15 Implant supported complete dentures

• Case 1 Maxillary extensive bone graft followed by implant supported bars and bar supported overdenture after managing a temporomandibular disorder. Flange needed for lip support necessitating a removable rather than a non-removable approach.
• Case 2 Severe maxillary and mandibular resorption; maxillary bone grafting; maxillary and mandibular implant supported bar and bar supported dentures. Flanges needed for lip and cheek support necessitating a removable rather than a non-removable approach

Chapter 16 Reconstructions on all natural teeth

• Case 1 Severe anterior overjet handled with occlusal/restorative treatment in lieu of orthognathics; muscular component of a temporomandibular disorder also managed
• Case 2 Failed multiple reconstructions. Original deep overbite with current condition in provisionals with an opened vertical dimension and anterior overjet. Managed with a new reconstruction harmonizing a physiologic deep overbite
• Case 3 Maxillary reconstruction combined with extractions and periodontal surgery to improve periodontal architecture. Landmarks of lower acceptable with minor modification
• Case 4 Full mouth reconstruction utilizing crown lengthening surgery, extractions, single crowns, veneers and a fixed partial denture sequenced over 2 years
• Case 5 Maxillary complete fixed partial denture on nine Galvano telescopic copings; mandibular anterior fixed partial denture on four Galvano copings
• See also: Chapter 6 Case 6
• Chapter 14 Case 3
• Chapter 14 Case 4

Appendix 1 Definitive Occlusal Therapy using the T-Scan-3 by Dr. Robert Kerstein
Appendix 2 What your laboratory technician needs to provide excellence by Jerry Ulysek, CDT