In the first row of pictures, 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 to increase vertical dimension.
The third row shows x-rays taken after the Endodontist completed eight root canals on the first day on teeth #’s: 6 – 11 and 14, 15.
The fourth row shows the lab-processed 11 unit (11 tooth) temporary dental bridge and the cast gold post/cores (with Kaitlyn loops) for the root canal treated teeth.
The fifth row of pictures shows the cast gold post/cores cemented with glass ionomer.
The sixth row of photos shows the lab-processed temporary dental bridge in place after the oral surgeon extracted teeth #’s: 3 – 5 and 12, crown lengthening periodontal gum surgery was performed on teeth #’s: 6 – 11, and a distal wedge was performed on tooth #15.
A one piece porcelain-metal dental bridge – full arch roundhouse bridge – will be made after the gums heal. Dental implants may also be placed in the upper right maxilla. A night guard is also necessary to try to mitigate the force of teeth grinding. Referral for pharmacological management of anxiety was also recommended.
A mandibular stabilization appliance with a braided brass lingual reinforcement, occlusal stainless steel mesh and ball clasps. This is used to treat myalgia-myositis secondary to bruxism. Note the extension up the lingual aspect of the anterior teeth without incisor coverage. Extra oral pictures of a night guard used in the treatment of teeth grinding clenching.