Restorative
“Her examination revealed several hopeless teeth”
Continued »
time wear (Fig 6). The final smile is shown in Figure 7.
Case study two This lady was referred with a failing dentition, periodontal disease and TMJ dysfunction (Fig 8). Her examination revealed several hopeless teeth and an almost edge to edge occlu- sion with limited anterior guidance on her anterior teeth. In view of the limited guidance
available, the fully-adjustable articulator was chosen as the posterior determinants of occlusion and posterior guidance (condyles) have a greater bearing on mandibular movements and occlusal anatomy. Following our standard diagnostic
procedures, several teeth were removed (Fig 9), prototypes relined with ‘Luxatemp’ (DMG) and fitted (Fig ı0), implants placed and the occlusion was adjusted so that RCP=ICP around RAP. A reorganised approach was used so as to reduce TMJ dysfunction and provide the patient with the ideal five principles of gnathology (occlusion). The articulator was programmed by
using a facebow (Fig ıı) and the cadiax (Denar) (Fig ı2) to record intercondylar distance, immediate and progressive side shifts and the shape of the superior and posterior walls of the fossa (Fig ı3). The goal of the restoration was to
move the maxillary teeth forwards and move the mandibular teeth posteriorly by occlusal adjustment, thereby establishing a deeper overbite and overjet and better anterior guidance (Fig ı4). The final smile is shown in Figure ı5.
Fig 11 – Facebow recording ABOUT THE AUTHOR Fig 10 – Protypes placed
A highly respected specialist in pros- thodontics, Paul has written many articles for the dental press and is an expert lecturer in his field with Tipton Training Academies in Manchester, London and Dublin. After gaining his Masters degree in conservative dentistry in 1989, he was awarded the Diploma in General Dental Practice by the Royal College of Surgeons four years later and received specialist status in prosthodontics in 1999 from the GDC.
He is currently the President of the British Academy of Restorative Dentistry (
www.bard.uk.com) and is a past-president of the British Academy of Implant Dentistry, He takes referrals at the
T.Clinic in Manchester and London (www.
drpaultipton.co.uk)
Fig 12 – Cadiax recording
Fig 13 – Restorations on the fully-adjustable articulator
Fig 14 – Full upper arch complete
Fig 15 – Final Smile – close-up Scottish Dental magazine 51
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