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.