Jeff Trembley, DDS
Complex restorative cases can be successfully managed with proper support. First, accurate records are needed, such as impressions, radiographs, facebow and bite records, and high-resolution photographs. Next, good “allies” are necessary, such as an experienced laboratory technician/ceramist whose interest in success aligns with the clinician’s and local specialists who can help manage the plan and treatment. In the present case, with proper records in hand, the author relied on his lab tech/ceramist “ally” (Macstudio By MicroDental Laboratories, macstudio.com) to supply materials to manage the entire case, including reduction guides, temporary stints, and a maxillary wax-up to increase the patient’s vertical dimension of occlusion (VDO). An initial minimal preparation day to remove old fillings and restorations and seat new temporaries served two purposes: a test drive for the patient’s new VDO and a guide for crown lengthening. Crown lengthening of teeth Nos. 9 through 11 to balance the tissue was performed by a periodontist “ally” (Robert Pulliam, DMD, MS, Nashville, Tennessee). After that, all that was needed was an afternoon of refining preparations, recording the VDO accurately, and replacing the temporaries.
Accurate records and photographs serve as the foundation upon which a restorative case is built.
A dependable laboratory partner in whom a clinician trusts with his or her records is indispensable.
Consultation with specialists on the front end of a case will help clinicians avoid missteps and often stimulates ideas not previously considered.
Jeff Trembley, DDS
Private Practice
Nashville, Tennessee
Figures and Images
Figure 1
Figure 2
Figure 3
Figure 4
Figure 5
Figure 6
Figure 7
Figure 8
Figure 9
Figure 10
Figure 11
Figure 12
Figure 13
