Oral Reconstruction of a phobic Wall Street executive. Total treatment time was about nine hours in two visits during one business week: Monday (four hours) and Friday (five hours). This patient hid his dental condition for over a decade by never smiling.
In the first row of photos, note that the bite was over-closed due to a prior history of an eating disorder, now controlled, and a current tooth grinding habit.
An Oral Surgery consultation with panoramic x-ray (second row) was performed prior to treatment to evaluate opening the bite.
The third row shows x-rays taken after the Endodontist completed eight root canals on the first day on tooth #’s: 6 – 11 and 14, 15.
The fourth row shows the lab-processed 11 unit (11 tooth) temporary bridge and the cast gold post/cores (with Kaitlyn loops) for the root canal treated teeth.
The fifth row shows the cast gold post/cores cemented.
The sixth row shows the lab-processed temporary bridge in place after the surgeon extracted tooth #’s: 3 – 5 and 12, crown lengthening gum surgery was performed on tooth #’s: 6 – 11, and a distal wedge was performed on #15.
The patient will have a final porcelain-metal bridge made after the gums heal. Implants may also be placed in the upper right posterior. A bite plate is also necessary to try to mitigate the force of tooth grinding. Referral for pharmacological management of anxiety is also worthwhile.
