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Monday, July 29, 2013

Re: [ACEsthetics] Treatment planning edentulous arches

Hard to say without photos or x-rays but she has to come to the realization that she's going to lose those 4 teeth.  No good option other than that.  Once she gets past that, she then has all options open to her.  Although not recommended, many patients sleep with their dentures, but I would look to some type of implant option.  $20K is not going to get her into a fixed hybrid and lower partial, at least not in my office.

if you don't do the immediate denture right away after sinus lifts and placement of implants, your just going to have to do it later.  That's a lot of money to spend to do the left side and the right side, only to be scrapped once she loses the front four.  If finances are limited here, she would be better off doing this right away.



On Mon, Jul 29, 2013 at 8:56 AM, Steve Markus <smarkus147545@comcast.net> wrote:
Ok, so how do you plan this case?
 
55 yo divorcee, doesn't smile, for good reason  -- when I saw her FMX she looks like 75 yo +
Doesn't like the idea of going to bed without teeth in, but the only viable maxillary teeth will be 7-10 which she insists she doesn't want to lose.
Mandible – 4 viable teeth – 20, 22, 27 28  = need to save money here, b/c budget, for now, is $20K  Planning crown sleeve coping lower so that if one tooth is lost, all is not lost and will invest future time and money in the maxilla.
 
Needs bilateral sinus lifts before posterior implants can be placed.  In my eyes, this one has to be a hybrid for the time being with future plans for better restorations once 7-10 are sacrificable.
 
 
Steve Markus
The Centre for Dentistry at Haddon
209 White Horse Pike
Haddon Heights, NJ 08035
www.SmileSouthJersey.com
856 SMILE S J
 
Sent: Monday, July 29, 2013 9:43 AM
Subject: Re: [ACEsthetics] Treatment planning edentulous arches
 
Ok, what about Prettau?  When would you decide to do that
rather than...?
 
Marc


On Mon, Jul 29, 2013 at 8:32 AM, Dr. Tim Hale <drtimhale@gmail.com> wrote:
What about the Prettau as an additional option, it is not a hybrid ?


On Mon, Jul 29, 2013 at 8:59 AM, Marc Whitmore <marc.whitmore@gmail.com> wrote:
You're right Mac...
The reason for my post was to smoke out those who do
fixed hybrids, and given the cost and complications, why not
just do fixed fixed?
 
Marc


On Mon, Jul 29, 2013 at 7:56 AM, Mchenry Lee <drmaclee@gmail.com> wrote:
Marc,
 
Remember, the diagnosis is always the same, in this case, edentulous arch. 
 
Recommended treatment is what patient wants as end result; removable, solid fitting removable, how solid do you they want it, something that never comes out!  Educate in a way they fully understand (by team member).  Let patient decide (they can't argue with their own decision), what they decide is none of your business.  You are there just to say it is a good treatment or not.
 
One treatment is to blend all food.  It is the most economical and done every day by millions of healthy people.
 
Mac
 
Reality is time and money.


On Mon, Jul 29, 2013 at 7:46 AM, Marc Whitmore <marc.whitmore@gmail.com> wrote:
Here are four common options for the edentulous arch:
 
1. Conventional full denture
2. Removable implant attached full denture
3. Implant retained fixed hybrid
4. Implant retained fixed bridgework
 
How do you decide which to do when?
What are your criteria
for treatment planning between the various options?
 
thanks
Marc Whitmore
 
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Plano, TX
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Marc Whitmore
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Dr. Tim Hale

Founder & Fellow, Academy of Comprehensive Esthetics

Learn more about upcoming events & The Academy of Comprehensive Esthetics at www.ACEsthetics.com


 
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Marc Whitmore
Plano, TX
www.whitmoredental.com
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www.CitySmilesStLouis.com

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