Sometimes we have patients who need to wear both a TMJ bite guard and also an orthodontic retainer. In those increasingly common cases we design one device, typically for the lower jaw, that is a combined retainer and TMJ bite guard. Photos on bite plate or night guard for TMJ bruxism or teeth grinding created in our NYC TMJ Bite Guards office.
Dental Reconstruction of a Wall Street executive who was afraid of dentistry who also needed a bite plate for bruxism. 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 teeth grinding bruxism 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 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. Dental 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.