Arun Nayyar DMD,MS. Atlanta, Georgia
Subject: Re: [ACEsthetics] New patient with bilateral TMJ surgery 16 yrs
ago
From: ARUN NAYYAR <arunnayyardmd@gmail.com>
Date: Wed, June 05, 2013 10:29 am
To: Frey Terry DDS J <terryfrey@relax2smile.com>
Cc: agoodman@agoodmandds.com, Steven Hill <dr.stevehill@shaw.ca>, Steve
Markus <smarkus147545@comcast.net>, Ace <acesthetics@googlegroups.com>
Subject: Re: [ACEsthetics] New patient with bilateral TMJ surgery 16 yrs
ago
From: Ashley Goodman <agoodman@agoodmandds.com>
Date: Tue, June 04, 2013 7:27 pm
To: arunnayyardmd@gmail.com
Cc: dr.stevehill@shaw.ca, smarkus147545@comcast.net, Ace
<acesthetics@googlegroups.com>
Here's one of those cases. This patient looked up at me with tears in his eyes after we put him in the FM splint and said, "Thanks doc! Now I can start eating solid food again." He gave me a big hug and the nurse while he was still crying for joy. Later on he told me that we gave him his life back. Very, very rewarding case (And I'm not talking money here).
------- Ash ------------------------------------ Ashley Goodman, DDS 8736 Lake Murray Blvd.#108 San Diego, Ca 92119 Phone: 619-697-6677 Fax: 619-697-6632 Email: agoodman@agoodmandds.comWeb: www.agoodmandds.com------------------------------------On 6/4/2013 4:11 PM, arunnayyardmd@gmail.com wrote:I was waiting for u to comment. Those of us who were practicing in the 1970s-90s when this surgery was hot have seen our share.
I agree with the vdo + calming and healing to no symptoms THEN restore IF needed
I will share more as this pt tx moves forward
She is v anti dental right now
Arun
The Centre for Dentistry at Haddon
209 White Horse Pike
Haddon Heights, NJ 08035
www.SmileSouthJersey.com
856 SMILE S J
Arun
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RE: [ACEsthetics] New patient with bilateral TMJ surgery 16 yrs ago
Trust me Arun, since you and I have spoken, I haven't done more than a single crown, some minor fillings, super easy anterior endos, LOTS of extractions, a LOT of Medicaid cheap dentures for which I make $50 clear, a few upper and better FFS dentures, prophys, cutting out perio to refer to specialists, cutting out implants, too much risk and time consuming. I only have maybe 4 years left, so I'm shipping out anything that is more than an average or less than average dentist can do. Takes away stress to heart and stomach lining away. Of course, cutting out so much Medicaid and doing them differently has reduce chaos and stress. I'm kind of floating, but still reading and listening and learning JUST for me. My patients don't require me to be anymore than I am. If I see something, I refer unless it is super simple. I hope this will let me make it another 4 years to 72 & then I'm out one way or the other. Thanks for your advice and guidance.
Terry
J Terry Frey, DDS
Advanced Dental Care
623 N State St/PO Box 1008
North Vernon, IN 47265
(Ofc)812-346-6884
(Cell)812-592-4057
-------- Original Message ----------
-- Terry
The Pan you see from Ash is Major facial reconstruction of Maxillary and Mandibular osseous structures
You clearly note the Condyle implants rehab,
lower arch surgical advancement
Maxillary reconstruction
Teeth are then restored to correct disparity
One very brilliant face and oral reconstruction by a great team of Surgeons and Dentist.
These types of procedures are big $$ in today's numbers would be over 250K Surgeon/OR/ Dentist and when we total the time invested
= there is more revenue doing Class II composite restorations.
On Tue, Jun 4, 2013 at 7:43 PM, <terryfrey@relax2smile.com> wrote:
Ash and all ... I've never seen anything approaching this in my small rural practice in SE Indiana. What lead up to this? This is WAY off my chart.
Thanks,
Terry
J Terry Frey, DDS
Advanced Dental Care
623 N State St/PO Box 1008
North Vernon, IN 47265
(Ofc)812-346-6884
(Cell)812-592-4057
-------- Original Message --------
Sent via BlackBerry from T-Mobile
From: Ashley Goodman <agoodman@agoodmandds.com>
Date: Tue, 04 Jun 2013 16:04:07 -0700
ReplyTo: agoodman@agoodmandds.com
Subject: Re: [ACEsthetics] New patient with bilateral TMJ surgery 16 yrs ago
I've done these cases very successfully. Prior to the FMR definitly place the patient in a full splint that doesn't have any occusal locks and do constant adjustments. WAIT FOR HEALING! and the patient to be in a comfortable position. Section the splint as you restore each area so as not to loose the jaw position. CR and NM are pretty much useless with no condyles, TMJ, etc. All the patient has is a fibrous joint that shrinks just like scare tissue and also adhesions. Fun cases.------- Ash ------------------------------------ Ashley Goodman, DDS 8736 Lake Murray Blvd.#108 San Diego, Ca 92119 Phone: 619-697-6677 Fax: 619-697-6632 Email: agoodman@agoodmandds.comWeb: www.agoodmandds.com------------------------------------On 6/4/2013 11:22 AM, Steve Hill wrote:
IMHO....posterior compression is the potential issue here. This issue is bad enough when the articular disk is not in place...but no condyles?? If you put a deprogrammer in the anterior, what do you think the force vector of the masseter muscles will tend to do to the mandibular plane??
The TENS will actually place the masseters close to their physiological resting length. But no matter what what is done to determine the bite/mandibular position, please place a full occlusal coverage appliance....
Respectfully,
Steve
From: Steve Markus
Sent: Monday, June 03, 2013 7:48 PM
To: arunnayyardmd@gmail.com ; Ace
Subject: Re: [ACEsthetics] New patient with bilateral TMJ surgery 16 yrs ago
Keep it simple – soft diet, deptrogrammer, rocabado pt referral.
Steve Markus
From: ARUN NAYYAR
Sent: Monday, June 03, 2013 9:26 PM
To: Ace
Subject: [ACEsthetics] New patient with bilateral TMJ surgery 16 yrs ago
Hi Friends
New referral 46yr old female, bilateral condylectomies 16 yrs ago. Had endo 6m ago and restorative.... long appt. Now she has pain in her muscles and is blaiming her Dentist caused it by keeping her mouth open a long time.
SO all the occlusodontists here.. how would you manage this patient.??
I will appreciate your guidance
Arun Nayyar DMD,MS. Atlanta, Georgia
Private practice limited to Prosthodontics - Imagix Dental Group
Former Director of Fixed Prosthodontics - MCG School of Dentistry
Principle Research Scientist ( Adjunct ) @ GaTech -GTRI
Clinical Director - Center for Dental Technology @ GaTech - GTRI
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