North Texas Dentistry Volume 10 Issue 1 2020 ISSUE 1 DE | Page 22

SMILES SPOTLIGHT in the LEADERS IN NORTH TEXAS DENTISTRY CREATING UNFORGETTABLE SMILES Multidisciplinary Orthodontic-Oral Surgery-Restorative Dental Management of Adult Female Patient with Severely Worn Dentition Deji V. Fashemo, DDS, MPH in collaboration with Drs. Anna Willison (Restorative Dentist) and Randy Sanovich (Oral Surgeon) PATIENT PRESENTATION Adult female patient presented to her dentist to discuss restoration of severely worn-down teeth and smile enhancement. On examination the maxillary anterior teeth were found to have only about half of the clinical crowns remaining, and they were in contact with the mandibular anterior teeth. Patient was referred for orthodontic evaluation and discussion of alternatives to re-establish interocclusal clearance for optimal restorative work. Orthodontic examination and analysis show that the mandibular anterior teeth were severely over-erupted and the 2-step occlusion and increased lower curve of Spee left the patient with no sagittal overjet clearance nor the required inter-occlusal clearance needed to restore her maxillary anterior teeth. 22 NORTH TEXAS DENTISTRY | www.northtexasdentistry.com TREATMENT PLAN Orthodontic treatment was aimed at achieving true mandibular anterior teeth intrusion in an effective and efficient manner. Restorative needs dictate the creation of enough inter-occlusal and sagittal overjet and clearance for opti- mal restorations on the maxillary anterior teeth. A referral was made for oral surgery consultation for extraction of a single mandibular incisor and place- ment of mandibular bone-anchored intrusion plates. Fixed orthodontic appli- ance treatment was initiated on the lower teeth; mandibular appliances were placed about six months into treatment.