Dentistry - Implants, partials, Another case

Author

Implants, partials, Another case

quattrocchi

2005-01-27, 7:19 am

I've been watching the various discussions about what's possible with
interest. I was interested in James' recent thread 'Implants or partials,
or both?' and emboldened to also show my horrific xray. I've grown up in a
small town area where the norm was full dentures by age 18. Sounds amazing
nowadays, but that was the way then. I guess they thought it was some type
of modern technological advance. Anyway my teeth were well filled and
several pulled by the time I was 20, with triple abcesses in the bottom
front. However I was convinced that the best action was whatever allowed
me to retain my own teeth.

Now in my mid-50s I have quite a wavy bone line from the gaps,
over-eruptions, teeth reconstructed to the limit, and a few root fillings.
The over-erupted upper molar is painful to cold/hot, so it's time to try
prosthodontics.

I had the molds done in December and am about to be called into my fixed
prosthodontic clinic. I asked for a variety of options at this point, with
a similar variety of costings. I can't afford a mouthful of work.

I hope for a return to chewing well on both sides and that the variety of
options will extend to what's available worldwide.

Here's the state of my teeth www.adam.co.nz/xray/jpg
As was pointed out to me there will be some bone and gum reconstruction
needed in places, esp where there are missing teeth.

Any thoughts here on what I could expect in the way of options?

Thanks

Brian
--
Auckland NEW ZEALAND

Bill

2005-01-27, 7:19 am

quattrocchi wrote:
> I've been watching the various discussions about what's possible with
> interest. I was interested in James' recent thread 'Implants or
partials,
> or both?' and emboldened to also show my horrific xray. I've grown up
in a
> small town area where the norm was full dentures by age 18. Sounds
amazing
> nowadays, but that was the way then. I guess they thought it was some
type
> of modern technological advance. Anyway my teeth were well filled and
> several pulled by the time I was 20, with triple abcesses in the
bottom
> front. However I was convinced that the best action was whatever
allowed
> me to retain my own teeth.
>
> Now in my mid-50s I have quite a wavy bone line from the gaps,
> over-eruptions, teeth reconstructed to the limit, and a few root
fillings.
> The over-erupted upper molar is painful to cold/hot, so it's time to
try
> prosthodontics.
>
> I had the molds done in December and am about to be called into my
fixed
> prosthodontic clinic. I asked for a variety of options at this point,
with
> a similar variety of costings. I can't afford a mouthful of work.
>
> I hope for a return to chewing well on both sides and that the
variety of
> options will extend to what's available worldwide.
>
> Here's the state of my teeth www.adam.co.nz/xray/jpg
> As was pointed out to me there will be some bone and gum
reconstruction
> needed in places, esp where there are missing teeth.
>
>
> Any thoughts here on what I could expect in the way of options?
>
> Thanks
>
> Brian
> --
> Auckland NEW ZEALAND

Brian: the correct URL for your xray is:
http://www.adam.co.nz/xray.jpg
instead of the www.adam.co.nz/xray/jpg you mentioned above.

It's amazing how a slash instead of a dot can make all the difference!

Anyway, the panoramic film posted is difficult to read, due in part to
the severe half-toning of the image. Try resetting the scanner to
eliminate the "newspaper half-tone" effect and see if that's any
better.

Regards,
- dentaldoc

Joel M. Eichen

2005-01-27, 7:19 am

I could not see it.

Joel

On Mon, 24 Jan 2005 19:00:50 +1300, quattrocchi <quattrocchi@ww.co.nz>
wrote:

>I've been watching the various discussions about what's possible with
>interest. I was interested in James' recent thread 'Implants or partials,
>or both?' and emboldened to also show my horrific xray. I've grown up in a
>small town area where the norm was full dentures by age 18. Sounds amazing
>nowadays, but that was the way then. I guess they thought it was some type
>of modern technological advance. Anyway my teeth were well filled and
>several pulled by the time I was 20, with triple abcesses in the bottom
>front. However I was convinced that the best action was whatever allowed
>me to retain my own teeth.
>
>Now in my mid-50s I have quite a wavy bone line from the gaps,
>over-eruptions, teeth reconstructed to the limit, and a few root fillings.
>The over-erupted upper molar is painful to cold/hot, so it's time to try
>prosthodontics.
>
>I had the molds done in December and am about to be called into my fixed
>prosthodontic clinic. I asked for a variety of options at this point, with
>a similar variety of costings. I can't afford a mouthful of work.
>
>I hope for a return to chewing well on both sides and that the variety of
>options will extend to what's available worldwide.
>
>Here's the state of my teeth www.adam.co.nz/xray/jpg
>As was pointed out to me there will be some bone and gum reconstruction
>needed in places, esp where there are missing teeth.
>
>
>Any thoughts here on what I could expect in the way of options?
>
>Thanks
>
>Brian

Joel M. Eichen

2005-01-27, 7:19 am

On 24 Jan 2005 01:39:23 -0800, "Bill" <dentaldoc@hotmail.com> wrote:

>reconstruction

Two or three fixed bridges. This should take a couple of months and
should not be outrageously expensive.

If you want a more complete plan, some clear peripaical (around the
roots) x-rays would be helpful.

Joel

[vbcol=seagreen]
>
>

quattrocchi

2005-01-27, 7:19 am

In article <duu9v0lvrohh3odphlg1fobng86sr189bd@4ax.com>,
Joel M. Eichen <joeleichen@yahoo.com> wrote:
> Two or three fixed bridges. This should take a couple of months and
> should not be outrageously expensive.
> If you want a more complete plan, some clear peripaical (around the
> roots) x-rays would be helpful.
> Joel

Excuse me. On my OS the dots are slashes. No escuse.

Here's a better one

www.adam.co.nz/xray.jpg [64k]

and a bigger one

www.adam.co.nz/xray_324k.jpg

B

Steven Fawks

2005-01-27, 7:19 am

No offense, but it looks a lot tougher than that to me.
(at least if you want it to last more than 5 years)

JMO,
Fawks

> Two or three fixed bridges. This should take a couple of months and
> should not be outrageously expensive.
>
> If you want a more complete plan, some clear peripaical (around the
> roots) x-rays would be helpful.
>
>
> Joel
>
>
>
>
>

Joel M. Eichen

2005-01-27, 7:20 am

On Tue, 25 Jan 2005 09:15:58 +1300, quattrocchi <quattrocchi@ww.co.nz>
wrote:

>In article <duu9v0lvrohh3odphlg1fobng86sr189bd@4ax.com>,
> Joel M. Eichen <joeleichen@yahoo.com> wrote:
>
>Excuse me. On my OS the dots are slashes. No escuse.
>
>Here's a better one
>
> www.adam.co.nz/xray.jpg [64k]
>
> and a bigger one
>
> www.adam.co.nz/xray_324k.jpg
>
>B

Nixce x-ray.

The back upper molar (UR as we view it) appears
to be abscessed. This will compromise bridgwork.

We gotta discuss this .......

Any ideas from the dentists?

Joel

Joel M. Eichen

2005-01-27, 7:20 am

On Mon, 24 Jan 2005 21:58:59 GMT, Steven Fawks
<tuthjockey@earthlink.net> wrote:

>
>
>No offense, but it looks a lot tougher than that to me.
>(at least if you want it to last more than 5 years)
>
>JMO,
>Fawks

YUP, I just saw the better x-ray ...... there are complications.

What would you suggest?

Joel

[vbcol=seagreen]
>
>

Bill

2005-01-27, 7:20 am

quattrocchi wrote:
> In article <duu9v0lvrohh3odphlg1fobng86sr189bd@4ax.com>,
> Joel M. Eichen <joeleichen@yahoo.com> wrote:
>
> Excuse me. On my OS the dots are slashes. No escuse.
>
> Here's a better one
>
> www.adam.co.nz/xray.jpg [64k]
>
> and a bigger one
>
> www.adam.co.nz/xray_324k.jpg
>
> B

These pictures are much better. A set of periapicals would be better
yet, as they show more detail than a single panoramic film, but this
film gives a general idea.

It looks like a large crown & bridge case, which is not uncommon.
Assuming the periodonal condition can be improved and controlled, three
fixed bridges ought to replace the missing teeth, although implants
there -- expecially in the larger edentulous areas -- are usually
preferable to long-span bridges. So one fixed bridge and several
implants is another alternative.

A couple of the lower molars seem to have restorations almost into the
furcations, so that would take close examination to determine whether
crowns or endo would be needed.

So it might involve bridges, implants, perio treatment, and a few
crowns and possible endodontics. Is that about what you have planned?
Regards,
- dentaldoc

Dr. Steve

2005-01-31, 11:15 am

On Mon, 24 Jan 2005 21:58:59 GMT, Steven Fawks
<tuthjockey@earthlink.net> wrote:
[vbcol=seagreen]
>
>
>No offense, but it looks a lot tougher than that to me.
>(at least if you want it to last more than 5 years)
>
>JMO,
>Fawks
>
>

I would suggest full equilibration to a synchronous occlusion with two
acrylic partials. Then, re-evaluate for prosthetics, Endodontics, etc.
...
Stephen Mancuso, D.D.S.
Troy, Michigan, USA

I am writing on a Tablet-PC,so forgive me if the PC misreads my handwriting.

W_B

2005-01-31, 11:15 am

On Fri, 28 Jan 2005 14:46:01 GMT, Dr. Steve <drsteve@no-spam.com> wrote:

>On Mon, 24 Jan 2005 21:58:59 GMT, Steven Fawks
><tuthjockey@earthlink.net> wrote:
>
>
>I would suggest full equilibration to a synchronous occlusion with two
>acrylic partials. Then, re-evaluate for prosthetics, Endodontics, etc.
>..
>Stephen Mancuso, D.D.S.
>Troy, Michigan, USA

I recommend a trip to Troy, Michigan, USA for treatment.
--

W_B

Take out the G'RBAGE
wubbabubbazG@RBAGEyahoo.com

Dr. Steve

2005-01-31, 11:15 am

On Fri, 28 Jan 2005 16:15:07 GMT, W_B <no_one@nowhere.net> wrote:

>On Fri, 28 Jan 2005 14:46:01 GMT, Dr. Steve <drsteve@no-spam.com> wrote:
>
>
>
>I recommend a trip to Troy, Michigan, USA for treatment.

Only if Dr. George comes from DC
...
Stephen Mancuso, D.D.S.
Troy, Michigan, USA

I am writing on a Tablet-PC,so forgive me if the PC misreads my handwriting.

W_B

2005-01-31, 11:15 am

On Fri, 28 Jan 2005 16:22:17 GMT, Dr. Steve <drsteve@no-spam.com> wrote:

>
>Only if Dr. George comes from DC
>..
>Stephen Mancuso, D.D.S.

Deal.
--

W_B

Take out the G'RBAGE
wubbabubbazG@RBAGEyahoo.com

quattrocchi

2005-01-31, 11:15 am

In article <1106728856.145990.50610@z14g2000cwz.googlegroups.com>,
Bill <dentaldoc@hotmail.com> wrote:
> It looks like a large crown & bridge case, which is not uncommon.
> Assuming the periodonal condition can be improved and controlled, three
> fixed bridges ought to replace the missing teeth, although implants
> there -- expecially in the larger edentulous areas -- are usually
> preferable to long-span bridges. So one fixed bridge and several
> implants is another alternative.
> A couple of the lower molars seem to have restorations almost into the
> furcations, so that would take close examination to determine whether
> crowns or endo would be needed.
> So it might involve bridges, implants, perio treatment, and a few
> crowns and possible endodontics. Is that about what you have planned?

I've yet to see my prosthodontic man here, who is as we speak (I hope)
making up from the castings he took of my mouth some choices of treatment.
I'd like the choice of costings, though I guess cost equates to
durability.
My prosthodontic man also tells me that as a result of the bruxia-induced
wavy dental line I have bone and gum decline in some parts and overgrowth
in other parts. 'Periodonal condition'? So he's getting me to see a bone
person and a gum person (excuse the lo-tech terms) for their evuations as
to correcting this.
Note that overerupted tooth. It's temperature sensitive now. what's
possible there?

In article <e3knv05f177gpm1noarn77sg3qlb42mbg2@4ax.com>,
W_B <no_one@nowhere.net> wrote:
> On Fri, 28 Jan 2005 14:46:01 GMT, Dr. Steve <drsteve@no-spam.com> wrote:
> I recommend a trip to Troy, Michigan, USA for treatment.

Yes... ;) Might I assume then that the synchronous occlusion with two
acrylic partials is a temporary solution? Sounds cheapest! How temporay?
So what's the reason for this two-part treatment? Are there things that
will become eveident after fitting the partials, and/or is a settling down
period advised?

Brian

--
Auckland NEW ZEALAND

Roy Brown

2005-01-31, 11:15 am

W_B

2005-01-31, 11:15 am

On Fri, 28 Jan 2005 16:04:46 -0500, "Roy Brown"
<roybrown@sympatico.caNADA> wrote:

>
>
>
>"W_B" <no_one@nowhere.net> wrote in message
>news:cptnv0hadqctbgn5aqgqfsrkighjbn7dnr@4ax.com...
>| On Fri, 28 Jan 2005 16:22:17 GMT, Dr. Steve <drsteve@no-spam.com> wrote:
>|
>| >>>
>| >>>I would suggest full equilibration to a synchronous occlusion with two
>| >>>acrylic partials. Then, re-evaluate for prosthetics, Endodontics, etc.
>| >>>..
>| >>>Stephen Mancuso, D.D.S.
>| >>>Troy, Michigan, USA
>| >>
>| >>
>| >>I recommend a trip to Troy, Michigan, USA for treatment.
>| >
>| >Only if Dr. George comes from DC
>| >..
>| >Stephen Mancuso, D.D.S.
>|
>| Deal.
>| --
>|
>| W_B
>|
>| Take out the G'RBAGE
>| wubbabubbazG@RBAGEyahoo.com
>
>You need a denturist as part of the treatment team?

Without a doubt.

--
W_B

wubbabubbazG@RBAGEyahoo.com
Take out the G'RBAGE

Joel M. Eichen

2005-01-31, 11:15 am

On Fri, 28 Jan 2005 23:37:36 GMT, W_B <no_one@nowhere.net> wrote:

>
>Without a doubt.

If its in Troy Michigan, go incognito!

Dr. Steve

2005-01-31, 11:15 am

On Fri, 28 Jan 2005 16:04:46 -0500, "Roy Brown"
<roybrown@sympatico.caNADA> wrote:

>
>
>
>"W_B" <no_one@nowhere.net> wrote in message
>news:cptnv0hadqctbgn5aqgqfsrkighjbn7dnr@4ax.com...
>| On Fri, 28 Jan 2005 16:22:17 GMT, Dr. Steve <drsteve@no-spam.com> wrote:
>|
>| >>>
>| >>>I would suggest full equilibration to a synchronous occlusion with two
>| >>>acrylic partials. Then, re-evaluate for prosthetics, Endodontics, etc.
>| >>>..
>| >>>Stephen Mancuso, D.D.S.
>| >>>Troy, Michigan, USA
>| >>
>| >>
>| >>I recommend a trip to Troy, Michigan, USA for treatment.
>| >
>| >Only if Dr. George comes from DC
>| >..
>| >Stephen Mancuso, D.D.S.
>|
>| Deal.
>| --
>|
>| W_B
>|
>| Take out the G'RBAGE
>| wubbabubbazG@RBAGEyahoo.com
>
>You need a denturist as part of the treatment team?

Absolutely could use one.
...
Stephen Mancuso, D.D.S.
Troy, Michigan, USA

I am writing on a Tablet-PC,so forgive me if the PC misreads my handwriting.

Dr. Steve

2005-01-31, 11:15 am

On Sat, 29 Jan 2005 08:06:54 +1300, quattrocchi <quattrocchi@ww.co.nz>
wrote:

>In article <1106728856.145990.50610@z14g2000cwz.googlegroups.com>,
> Bill <dentaldoc@hotmail.com> wrote:
>
>I've yet to see my prosthodontic man here, who is as we speak (I hope)
>making up from the castings he took of my mouth some choices of treatment.
>I'd like the choice of costings, though I guess cost equates to
>durability.
>My prosthodontic man also tells me that as a result of the bruxia-induced
>wavy dental line I have bone and gum decline in some parts and overgrowth
>in other parts. 'Periodonal condition'? So he's getting me to see a bone
>person and a gum person (excuse the lo-tech terms) for their evuations as
>to correcting this.
>Note that overerupted tooth. It's temperature sensitive now. what's
>possible there?
>
>In article <e3knv05f177gpm1noarn77sg3qlb42mbg2@4ax.com>,
> W_B <no_one@nowhere.net> wrote:
>
>Yes... ;) Might I assume then that the synchronous occlusion with two
>acrylic partials is a temporary solution? Sounds cheapest! How temporay?
>So what's the reason for this two-part treatment? Are there things that
>will become eveident after fitting the partials, and/or is a settling down
>period advised?
>
>Brian

In order to be able to do *ANY* restoration of your mouth, you have to
stabilize the occlusion first. Achieving a synchronous occlusion at
the begin inning gives you a pre-determined occlusion to build to. It
also, provides reasonable temporary function. So this becomes
diagnostic as well as transitional.
...
Stephen Mancuso, D.D.S.
Troy, Michigan, USA

I am writing on a Tablet-PC,so forgive me if the PC misreads my handwriting.

Joel M. Eichen

2005-01-31, 11:15 am

On Sat, 29 Jan 2005 02:08:18 GMT, Dr. Steve <drsteve@no-spam.com>
wrote:

>
>Absolutely could use one.
>..
>Stephen Mancuso, D.D.S.
>Troy, Michigan, USA

But not in Michigan correct?

Montana, yes.

Joel

Dr. Steve

2005-01-31, 11:15 am

On Sat, 29 Jan 2005 07:17:08 -0500, Joel M. Eichen
<joeleichen@yahoo.com> wrote:

>On Sat, 29 Jan 2005 02:08:18 GMT, Dr. Steve <drsteve@no-spam.com>
>wrote:
>
>
>But not in Michigan correct?
>
>Montana, yes.
>
>
>Joel

There would be plenty of "legal" ways to use the talents of a man such
as Roy. Sharing a practice with him would be fantastic. Add in
George's skills and we would be like the "A-Team".
...
Stephen Mancuso, D.D.S.
Troy, Michigan, USA

I am writing on a Tablet-PC,so forgive me if the PC misreads my handwriting.

Joel M. Eichen

2005-01-31, 11:15 am

On Sat, 29 Jan 2005 18:50:34 GMT, Dr. Steve <drsteve@no-spam.com>
wrote:

>On Sat, 29 Jan 2005 07:17:08 -0500, Joel M. Eichen
><joeleichen@yahoo.com> wrote:
>
>
>There would be plenty of "legal" ways to use the talents of a man such
>as Roy. Sharing a practice with him would be fantastic. Add in
>George's skills and we would be like the "A-Team".

Yup ......

Joel

>..
>Stephen Mancuso, D.D.S.
>Troy, Michigan, USA
>
>I am writing on a Tablet-PC,so forgive me if the PC misreads my handwriting.

Roy Brown

2005-01-31, 11:15 am

"Dr. Steve" <drsteve@no-spam.com> wrote in message
news:vjmnv0l3bum5ot2noohnj9rtudgn9lum9f@4ax.com...
| On Sat, 29 Jan 2005 07:17:08 -0500, Joel M. Eichen
| <joeleichen@yahoo.com> wrote:
|
| >On Sat, 29 Jan 2005 02:08:18 GMT, Dr. Steve <drsteve@no-spam.com>
| >wrote:
| >
| >>>You need a denturist as part of the treatment team?
| >>
| >>Absolutely could use one.
| >>..
| >>Stephen Mancuso, D.D.S.
| >>Troy, Michigan, USA
| >
| >But not in Michigan correct?
| >
| >Montana, yes.
| >
| >
| >Joel
|
| There would be plenty of "legal" ways to use the talents of a man such
| as Roy. Sharing a practice with him would be fantastic. Add in
| George's skills and we would be like the "A-Team".
| ..
| Stephen Mancuso, D.D.S.
| Troy, Michigan, USA
|
| I am writing on a Tablet-PC,so forgive me if the PC misreads my handwriting.

I could handle being an in house tech for a couple of days. I'm sure that Steve
and George could divvy up the impressions bite, try in and insertion between
them. Alternatively, it is a quick jaunt across the border to Windsor (where I'm
legally qualified to practice) I am sure I could borrow an operatory and a
beautiful Kavo equipped lab of a Denturist I've met there. If not, then either
Sarnia or Leamington are possibilities. Maybe even make a side trip or two to
the Casino.

Steve, does Michigan have any exclusion on their licensing requirements when it
comes to educational endeavours? I know we do.
--
Roy
rem NADA to reply

Dr. Steve

2005-01-31, 11:15 am

On Sat, 29 Jan 2005 16:41:27 -0500, "Roy Brown"
<roybrown@sympatico.caNADA> wrote:

>"Dr. Steve" <drsteve@no-spam.com> wrote in message
>news:vjmnv0l3bum5ot2noohnj9rtudgn9lum9f@4ax.com...
>| On Sat, 29 Jan 2005 07:17:08 -0500, Joel M. Eichen
>| <joeleichen@yahoo.com> wrote:
>|
>| >On Sat, 29 Jan 2005 02:08:18 GMT, Dr. Steve <drsteve@no-spam.com>
>| >wrote:
>| >
>| >>>You need a denturist as part of the treatment team?
>| >>
>| >>Absolutely could use one.
>| >>..
>| >>Stephen Mancuso, D.D.S.
>| >>Troy, Michigan, USA
>| >
>| >But not in Michigan correct?
>| >
>| >Montana, yes.
>| >
>| >
>| >Joel
>|
>| There would be plenty of "legal" ways to use the talents of a man such
>| as Roy. Sharing a practice with him would be fantastic. Add in
>| George's skills and we would be like the "A-Team".
>| ..
>| Stephen Mancuso, D.D.S.
>| Troy, Michigan, USA
>|
>| I am writing on a Tablet-PC,so forgive me if the PC misreads my handwriting.
>
>I could handle being an in house tech for a couple of days. I'm sure that Steve
>and George could divvy up the impressions bite, try in and insertion between
>them. Alternatively, it is a quick jaunt across the border to Windsor (where I'm
>legally qualified to practice) I am sure I could borrow an operatory and a
>beautiful Kavo equipped lab of a Denturist I've met there. If not, then either
>Sarnia or Leamington are possibilities. Maybe even make a side trip or two to
>the Casino.
>
>Steve, does Michigan have any exclusion on their licensing requirements when it
>comes to educational endeavours? I know we do.

Roy,

If you mean do we allow treatment beyond the parameters of licensing
regulations,,,,,, then no I do not think it is allowed, unless part of
a Government approved dental school and the work is then done under
the licensing of the supervising dentist (as I understand it).
...
Stephen Mancuso, D.D.S.
Troy, Michigan, USA

I am writing on a Tablet-PC,so forgive me if the PC misreads my handwriting.

Roy Brown

2005-01-31, 11:15 am

"Dr. Steve" wrote
"Roy Brown" wrote:
| >
| >I could handle being an in house tech for a couple of days. I'm sure that
Steve
| >and George could divvy up the impressions bite, try in and insertion between
| >them. Alternatively, it is a quick jaunt across the border to Windsor (where
I'm
| >legally qualified to practice) I am sure I could borrow an operatory and a
| >beautiful Kavo equipped lab of a Denturist I've met there. If not, then
either
| >Sarnia or Leamington are possibilities. Maybe even make a side trip or two to
| >the Casino.
| >
| >Steve, does Michigan have any exclusion on their licensing requirements when
it
| >comes to educational endeavours? I know we do.
|
|
| Roy,
|
| If you mean do we allow treatment beyond the parameters of licensing
| regulations,,,,,, then no I do not think it is allowed, unless part of
| a Government approved dental school and the work is then done under
| the licensing of the supervising dentist (as I understand it).
| ..
| Stephen Mancuso, D.D.S.
| Troy, Michigan, USA
|
| I am writing on a Tablet-PC,so forgive me if the PC misreads my handwriting.

We have something like that.too. Not sure if applies to Full time courses, might
also apply to part time or bonafide CE situations.
--
Roy
rem NADA to reply

StovePipe

2005-01-31, 11:15 am

Dr. Steve <drsteve@no-spam.com> wrote:

>
> In order to be able to do *ANY* restoration of your mouth, you have to
> stabilize the occlusion first. Achieving a synchronous occlusion at
> the begin inning gives you a pre-determined occlusion to build to. It
> also, provides reasonable temporary function. So this becomes
> diagnostic as well as transitional.
> ..

If it can be explained in writing, how would you make this occlusal
scheme 'synchronous'?
Thanks
SP
--
Not a real Addy, yet

Dr. Steve

2005-01-31, 11:15 am

On Sun, 30 Jan 2005 02:20:37 -0500, StovesNewAddy@sympatico.DOTnet
(StovePipe) wrote:

>Dr. Steve <drsteve@no-spam.com> wrote:
>
>
>If it can be explained in writing, how would you make this occlusal
>scheme 'synchronous'?
>Thanks
>SP

First, you need to correct the plane of occlusion. Then, remove
excursive interferences. When rubbing stone models of the final
occlusion together, it should almost feel like two ice cubes sliding
across each other. No bumps or clicks. Then, provide 2-3mm long
centric towards the distal. Then, give it some time to see if the
patient has any occlusal disease.
...
Stephen Mancuso, D.D.S.
Troy, Michigan, USA

I am writing on a Tablet-PC,so forgive me if the PC misreads my handwriting.

StovePipe

2005-01-31, 11:16 am

Dr. Steve <drsteve@no-spam.com> wrote:

> On Sun, 30 Jan 2005 02:20:37 -0500, StovesNewAddy@sympatico.DOTnet
> (StovePipe) wrote:
>
[vbcol=seagreen]
>
> First, you need to correct the plane of occlusion. Then, remove
> excursive interferences. When rubbing stone models of the final
> occlusion together, it should almost feel like two ice cubes sliding
> across each other. No bumps or clicks. Then, provide 2-3mm long
> centric towards the distal. Then, give it some time to see if the
> patient has any occlusal disease.
> ..
> Stephen Mancuso, D.D.S.
> Troy, Michigan, USA
>
> I am writing on a Tablet-PC,so forgive me if the PC misreads my handwriting.

So, basically, you'd have an almost 0-degree cuspid rise with long
centric stops... toward the distal to allow free protrusion, I would
think...

If I understand this correctly, there are any number of my patients who
would benefit from it.

One thing I read in an old 'Dental Clinics of North America' on
Prosthodontics: don't ignore the centric stop in the central fossa. If
it is weak, the occlusion is unstable and the tooth will move, since all
occlusion is now on inclines, usually angled in the same direction.

So, I can see why a long centric in the central fossa or groove would
be important.

Thanks!
SP
--
Not a real Addy, yet

quattrocchi

2005-02-01, 2:29 pm

In article <1gr81mg.1no7wxp2nomrbN%StovesNewAddy@sympatico.DOTnet>,
StovePipe <StovesNewAddy@sympatico.DOTnet> wrote:
> Dr. Steve <drsteve@no-spam.com> wrote:

In my case I have what I imagine to be an excursive interference in the
form of an over erupted maxillary 2nd molar. I have a commoner's attitude
towards retaining as many teeth as possible, and assume this one could be
chopped down and the root crowned so it doesn't extent down so much.
[vbcol=seagreen]

Hmm. Is this 2-3mm forward movement from the relaxed position?
[vbcol=seagreen]
[vbcol=seagreen]
> So, basically, you'd have an almost 0-degree cuspid rise with long
> centric stops... toward the distal to allow free protrusion, I would
> think...

Are 'long centric stops' the points where opposing teeth touch (and work)
and if they're long then the force is reduced?
What's a cuspid rise? the curve of spee?

(see, I've been reading up before I ask)

Brian

> One thing I read in an old 'Dental Clinics of North America' on
> Prosthodontics: don't ignore the centric stop in the central fossa. If
> it is weak, the occlusion is unstable and the tooth will move, since all
> occlusion is now on inclines, usually angled in the same direction.

> So, I can see why a long centric in the central fossa or groove would
> be important.

> Thanks!
> SP

--
Auckland NEW ZEALAND

Dr Steve

2005-02-03, 10:48 am

> So, basically, you'd have an almost 0-degree cuspid rise with long
> centric stops... toward the distal to allow free protrusion, I would
> think...

No, you can have inclines on your teeth. The slopes have to all be in
harmony with each other. As you slide up (or down) one slope, you don't
want to click over something else.

> If I understand this correctly, there are any number of my patients who
> would benefit from it.

Often

> One thing I read in an old 'Dental Clinics of North America' on
> Prosthodontics: don't ignore the centric stop in the central fossa. If
> it is weak, the occlusion is unstable and the tooth will move, since all
> occlusion is now on inclines, usually angled in the same direction.

That is from the school of occluSION, not the school of occluDING. If the
patient habituates in a lateral protrusive bracing position, having good
centric stops do not stabilize the occlusion. If the patient has an
isometric clench on the anterior teeth, the anterior splay outwards.
Eliminating parafunctional activity is what stabilizes the occlusion.

> So, I can see why a long centric in the central fossa or groove would
> be important.

The long centric is freedom towards the distal to allow the mandible to
position itself more distally, (not for protrusive movements) if it wants to
find CR. The key is not to create any interferences getting to CR. Then,
if the patient never goes to that elusive and strange RUM joint position,
you at least know there is not occlusal interference preventing it.

Take your next set of *un-articulated* stone models of a mouth with most of
its teeth in place. Hold the models in your hands with the teeth in CO and
the plane of occlusion at a right angle to your body and to the floor. Now,
softly rub the models in a circular motion. You will feel the interferences
with your hands (if you are gentle enough). Outline the spots in red,
remove a tiny bit of stone, and check again. You should end up with a
series of red circles around cuspal projections which interfere with
synchronous jaw movements. You can then use these marks as references as
far as where to adjust in the mouth (if there are not too many). If a lot
of adjustments was necessary on the models, this should probably done in
stages with new models each time.

I have to run back into the operatory, let me know if this makes more sense.

Dr Steve

2005-02-03, 10:48 am

Dear "4-eyes",

>
> In my case I have what I imagine to be an excursive interference in the
> form of an over erupted maxillary 2nd molar. I have a commoner's attitude
> towards retaining as many teeth as possible, and assume this one could be
> chopped down and the root crowned so it doesn't extent down so much.

You have the right idea

>
> Hmm. Is this 2-3mm forward movement from the relaxed position?

2-3 mm Freedom to move backward (if your jaw is capable of doing so after
relaxation of muscles). An additional 2-3 mm of forward movement is the
"normal" concept of Long Centric.

>
>
> Are 'long centric stops' the points where opposing teeth touch (and work)
> and if they're long then the force is reduced?
> What's a cuspid rise? the curve of spee?

If the contacts are in "long centric" the teeth have freedom to slide
forward and backward.

Cuspid rise is the functional occlusal scheme we are taught to persue in
dental school. I check every new patient to see if they have this or not.
Only about one person in twenty really has cuspid rise. In cuspid rise
cases, the cuspids are the only teeth touching as the mandible slides side
to side.

Curve of Spee relates to the curve to the plane of occlusion. Imagine a
piece of cardborad held between the teeth by biting on it. This is the
plane of occlusion. The curve of Spee is a specific curve along this plane.

> (see, I've been reading up before I ask)

>
> Brian
>
>
>
>
> --
> Auckland NEW ZEALAND
>

--
~+--~+--~+--~+--~+--
Stephen Mancuso, D.D.S.
Troy, Michigan, USA
.....................................................

This posting is intended for informational or conversational purposes only.
Always seek the opinion of a licensed dental professional before acting on
the advice or opinion expressed here. Only a dentist who has examined you
in person can diagnose your problems and make decisions which will affect
your health.
.......................

W_B

2005-02-03, 10:48 am

On Wed, 02 Feb 2005 18:00:02 GMT, "Dr Steve" <nospam@home.net> wrote:

>Curve of Spee relates to the curve to the plane of occlusion. Imagine a
>piece of cardborad held between the teeth by biting on it. This is the
>plane of occlusion. The curve of Spee is a specific curve along this plane.

Don't forget the Sphere of Monson.
--

W_B

Take out the G'RBAGE
wubbabubbazG@RBAGEyahoo.com

Roy Brown

2005-02-03, 10:48 am

"W_B" <no_one@nowhere.net> wrote in message
news:c5q4011pjbuo9ubnq6a9fm9aa94942i22o@4ax.com...
| On Wed, 02 Feb 2005 18:00:02 GMT, "Dr Steve" <nospam@home.net> wrote:
|
| >Curve of Spee relates to the curve to the plane of occlusion. Imagine a
| >piece of cardborad held between the teeth by biting on it. This is the
| >plane of occlusion. The curve of Spee is a specific curve along this plane.
|
|
| Don't forget the Sphere of Monson.

That definately rounds out the curve of Wilson when combined with Spee.

For the original poster:
Spee = front to back curve
Wilson = side to side curve
Spee + Wilson = Monson

Average radius of all is about 4" or 100mm
--
Roy

Roy Brown

2005-02-03, 10:48 am

"Dr Steve" <nospam@home.net> wrote in message
news:Cy8Md.25751$by5.6898@newssvr19.news.prodigy.com...
|
| You have the right idea
|
| >>> Then, provide 2-3mm long centric towards the distal.
| >
| > Hmm. Is this 2-3mm forward movement from the relaxed position?
|
| 2-3 mm Freedom to move backward (if your jaw is capable of doing so after
| relaxation of muscles). An additional 2-3 mm of forward movement is the
| "normal" concept of Long Centric.
|
| --
| ~+--~+--~+--~+--~+--
| Stephen Mancuso, D.D.S.
| Troy, Michigan, USA
| ....................................................

So that's the point I've been missing with Otto's Synchronized Occlusion

Thanks for pointing it out Steve!

--
Roy
rem NADA to reply

Dr Steve

2005-02-03, 10:48 am

I think two things stick out in the Horger concept of occlusal
synchronization. One is the 2-3 mm of distal freedom of movement, (this
way, you don't have to find CR, you just allow the mandible to go there if
it wants to). The other is the "feel" of rubbing two models together in
your hands and finding interferences by touch.

--
~+--~+--~+--~+--~+--
Stephen Mancuso, D.D.S.
Troy, Michigan, USA
.....................................................

This posting is intended for informational or conversational purposes only.
Always seek the opinion of a licensed dental professional before acting on
the advice or opinion expressed here. Only a dentist who has examined you
in person can diagnose your problems and make decisions which will affect
your health.
.......................
"Roy Brown" <roybrown@sympatico.caNADA> wrote in message
news:fKhMd.2870$lw4.672270@news20.bellglobal.com...
>
>
>
> "Dr Steve" <nospam@home.net> wrote in message
> news:Cy8Md.25751$by5.6898@newssvr19.news.prodigy.com...
> |
> | You have the right idea
> |
> | >>> Then, provide 2-3mm long centric towards the distal.
> | >
> | > Hmm. Is this 2-3mm forward movement from the relaxed position?
> |
> | 2-3 mm Freedom to move backward (if your jaw is capable of doing so
> after
> | relaxation of muscles). An additional 2-3 mm of forward movement is the
> | "normal" concept of Long Centric.
> |
> | --
> | ~+--~+--~+--~+--~+--
> | Stephen Mancuso, D.D.S.
> | Troy, Michigan, USA
> | ....................................................
>
> So that's the point I've been missing with Otto's Synchronized Occlusion
>
> Thanks for pointing it out Steve!
>
> --
> Roy
> rem NADA to reply
>
>

W_B

2005-02-03, 10:48 am

On Wed, 2 Feb 2005 23:17:46 -0500, "Roy Brown" <roybrown@sympatico.caNADA> wrote:

>"W_B" <no_one@nowhere.net> wrote in message
>news:c5q4011pjbuo9ubnq6a9fm9aa94942i22o@4ax.com...
>| On Wed, 02 Feb 2005 18:00:02 GMT, "Dr Steve" <nospam@home.net> wrote:
>|
>| >Curve of Spee relates to the curve to the plane of occlusion. Imagine a
>| >piece of cardborad held between the teeth by biting on it. This is the
>| >plane of occlusion. The curve of Spee is a specific curve along this plane.
>|
>|
>| Don't forget the Sphere of Monson.
>
>That definately rounds out the curve of Wilson when combined with Spee.
>
>For the original poster:
>Spee = front to back curve
>Wilson = side to side curve
>Spee + Wilson = Monson
>
>Average radius of all is about 4" or 100mm

And the center point is ?
--

W_B

Take out the G'RBAGE
wubbabubbazG@RBAGEyahoo.com

quattrocchi@ww.co.nz

2005-02-07, 8:26 am

Thanks for your kind explanations, Signor Mancuso.

Brian
-0-0-

posted from googlegroupsbeta, please forgive if repeats occur, or
editing is poor

MC60614

2005-02-07, 8:26 am

Center Point ? Hmm ? Middle..MC

Roy Brown

2005-02-07, 8:26 am

The more I think of it, Otto and I have been agreeing about the same concept all
along, with the language or terminology being the issue. Thanks for clarifying
this.
--
Roy

"Dr Steve" <nospam@home.net> wrote in message
news:HbpMd.259$hU7.183@newssvr33.news.prodigy.com...
|I think two things stick out in the Horger concept of occlusal
| synchronization. One is the 2-3 mm of distal freedom of movement, (this
| way, you don't have to find CR, you just allow the mandible to go there if
| it wants to). The other is the "feel" of rubbing two models together in
| your hands and finding interferences by touch.
|
| --
| ~+--~+--~+--~+--~+--
| Stephen Mancuso, D.D.S.
| Troy, Michigan, USA
| ....................................................
|
| This posting is intended for informational or conversational purposes only.
| Always seek the opinion of a licensed dental professional before acting on
| the advice or opinion expressed here. Only a dentist who has examined you
| in person can diagnose your problems and make decisions which will affect
| your health.
| ......................
| "Roy Brown" <roybrown@sympatico.caNADA> wrote in message
| news:fKhMd.2870$lw4.672270@news20.bellglobal.com...
| >
| >
| >
| > "Dr Steve" <nospam@home.net> wrote in message
| > news:Cy8Md.25751$by5.6898@newssvr19.news.prodigy.com...
| > |
| > | You have the right idea
| > |
| > | >>> Then, provide 2-3mm long centric towards the distal.
| > | >
| > | > Hmm. Is this 2-3mm forward movement from the relaxed position?
| > |
| > | 2-3 mm Freedom to move backward (if your jaw is capable of doing so
| > after
| > | relaxation of muscles). An additional 2-3 mm of forward movement is the
| > | "normal" concept of Long Centric.
| > |
| > | --
| > | ~+--~+--~+--~+--~+--
| > | Stephen Mancuso, D.D.S.
| > | Troy, Michigan, USA
| > | ....................................................
| >
| > So that's the point I've been missing with Otto's Synchronized Occlusion
| >
| > Thanks for pointing it out Steve!
| >
| > --
| > Roy
| > rem NADA to reply
| >
| >
|
|

W_B

2005-02-07, 8:26 am

On Thu, 3 Feb 2005 17:24:59 -0500, "Roy Brown"
<roybrown@sympatico.caNADA> wrote:

>| >| Don't forget the Sphere of Monson.
>| >
>| >That definately rounds out the curve of Wilson when combined with Spee.
>| >
>| >For the original poster:
>| >Spee = front to back curve
>| >Wilson = side to side curve
>| >Spee + Wilson = Monson
>| >
>| >Average radius of all is about 4" or 100mm
>|
>| And the center point is ?
>| --
>
>Off the top of my head, I want to say the Glabella, but I might be getting
>things mixed up. I recall that goes with the conical concept.

Hmmm...

Thought it was the Sella Tursica

--
W_B

wubbabubbazG@RBAGEyahoo.com
Take out the G'RBAGE

Joel M. Eichen

2005-02-07, 8:26 am

On Thu, 3 Feb 2005 17:24:59 -0500, "Roy Brown"
<roybrown@sympatico.caNADA> wrote:

>
>Off the top of my head, I want to say the Glabella, but I might be getting
>things mixed up. I recall that goes with the conical concept.
>--

Glabella is a version of plastic bag.

Roy Brown

2005-02-07, 8:26 am

"W_B" <no_one@nowhere.net> wrote in message
news:9qj5019f3mp4n3i9slf3p3optv7dfqca5u@4ax.com...
| On Thu, 3 Feb 2005 17:24:59 -0500, "Roy Brown"
| <roybrown@sympatico.caNADA> wrote:
|
| >| >| Don't forget the Sphere of Monson.
| >| >
| >| >That definately rounds out the curve of Wilson when combined with Spee.
| >| >
| >| >For the original poster:
| >| >Spee = front to back curve
| >| >Wilson = side to side curve
| >| >Spee + Wilson = Monson
| >| >
| >| >Average radius of all is about 4" or 100mm
| >|
| >| And the center point is ?
| >| --
| >
| >Off the top of my head, I want to say the Glabella, but I might be getting
| >things mixed up. I recall that goes with the conical concept.
|
|
| Hmmm...
|
| Thought it was the Sella Tursica
|
| --
| W_B

I looked it up. Glossary of Prosthodontic terms, 4th Ed. JPD/Mosby 1977 says:

Monson Curve. The curve of occlusion in which each cusp and incisal edge touches
or conforms to a segment of the surface of a sphere 8 inches in diameter with
its center in the region of the glabella.

--
Roy
rem NADA to reply

W_B

2005-02-07, 8:26 am

On Thu, 3 Feb 2005 20:06:20 -0500, "Roy Brown" <roybrown@sympatico.caNADA> wrote:

>| Hmmm...
>|
>| Thought it was the Sella Tursica
>|
>| --
>| W_B
>
>I looked it up. Glossary of Prosthodontic terms, 4th Ed. JPD/Mosby 1977 says:
>
>Monson Curve. The curve of occlusion in which each cusp and incisal edge touches
>or conforms to a segment of the surface of a sphere 8 inches in diameter with
>its center in the region of the glabella.
>
>--
>Roy

I'll buy that for a dollar.
--

W_B

Take out the G'RBAGE
wubbabubbazG@RBAGEyahoo.com

Bammers5

2005-02-07, 8:26 am

>The more I think of it, Otto and I have been agreeing about the same concept
>all
>along, with the language or terminology being the issue.

I can't even remember all of the cases that I have done where the teeth were
set (dentures) with the patient in CO and they return functioning in CO but
going to CR in a rest position. Would register the bite in CR, Remount case and
adjust the occlusion to accomodate a smooth transition from CO to CR.

Is this what Otto refers to?

keith

Dr. Steve

2005-02-07, 8:26 am

On 05 Feb 2005 00:49:33 GMT, bammers5@aol.comnojunk (Bammers5) wrote:

>
>I can't even remember all of the cases that I have done where the teeth were
>set (dentures) with the patient in CO and they return functioning in CO but
>going to CR in a rest position. Would register the bite in CR, Remount case and
>adjust the occlusion to accomodate a smooth transition from CO to CR.
>
>Is this what Otto refers to?
>
>keith

He creates it in his original occlusal scheme.
...
Stephen Mancuso, D.D.S.
Troy, Michigan, USA

I am writing on a Tablet-PC,so forgive me if the PC misreads my handwriting.

Roy Brown

2005-02-12, 1:30 pm

Roy Brown

2005-02-12, 1:30 pm

Dr Steve

2005-02-12, 1:30 pm