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When a patient comes to your office with a
desire to improve his or her smile, where do you begin? Is a
veneer case really different from crowns or a full mouth
rehabilitation, or one that will require implants? The simple
answer is “no.”
All restorative dentistry should be based on
the same sequence of analysis and case construction. Every case,
no matter how straight forward or complex, demands answers to
the same basic questions:
•Where do the teeth go in the face? (the smile
line)
•Where do they go in relation to one another?
(the occlusion)
•How are they individually shaped? (aesthetics
and function)
This program presents a step-by-step blueprint
for case analysis and sequencing that can be applied to every
case to produce an aesthetic and functional restoration, in a
predictable way, every time. Beautiful, natural smiles have many
variations, but all conform to the same functional guidelines
that allow them to be cosmetic and maintainable over time. All
prosthetic cases must follow these same functional guidelines.
Rules of function will determine every tooth contour, position,
and opposing contact – and the aesthetic result.
Key to this approach is close cooperation
between the doctor and the technician.
Guidelines are given that detail what the
doctor must send to the laboratory, and what the laboratory’s
responsibilities are in return.
Case analysis always starts with the
temporomandibular joint. The jaw opens and closes on a hinge
axis, the center of which is the joint. Using a face bow and
articulator, diagnostic casts can be mounted to accurately
reproduce the patient’s jaw position and movement on an
instrument outside the mouth. Once this is done, case planning
always begins with the upper central incisors. Their shape and
position in the face and, specifically, the smile line, is the
key to the restoration An occlusal scheme that is simple to
learn and construct is presented that determines the placement
and interrelationships of cusp tips. By involving the laboratory
at the beginning of the treatment process, through the shared
analysis of photographs and casts, the technician can create an
aesthetic and functional diagnostic wax-up that becomes the
blueprint for the case. The wax-up is used to create a
provisional that previews the final restoration for both the
doctor and the patient, and then becomes the template for the
laboratory to fabricate the final restoration. Cases constructed
in this way combine both beauty and function.
At the end of the day, you will return
to your office with a detailed blueprint for restorative success
that you can use right away.
Program Highlights:
1.The Fundamentals of Restorative
Dentistry:
◦Temporomandibular joint anatomy and function
◦Articulators and facebows (theory and
practice)
◦Occlusal theory
◦Occlusal scheme
■Centric holding contacts
■Anterior guidance
■Posterior disclusion
◦Centric relation, maximum intercuspation
◦Vertical dimension – when to open and when
you can’t
◦Neutral zone
◦Envelope of function
◦Jaw muscles
◦Anterior deprogrammers
◦Bite registrations
2.Doctor – Laboratory Communication and
Coordination
◦Articulator mountings
◦Clinical photography
◦Doctor mock-ups
◦Laboratory diagnostic wax-ups
◦Model preparation guides
◦Preparation putty indices
◦Provisional putty indices
3.Case Sequencing
◦Implants
◦Crowns
◦Veneers
4.Case examples – detailed, step
by step
CV
Dr. Ron Margolies graduated from the
University of Pennsylvania School of Dental Medicine and trained
at St. Alban’s Naval
Hospital, Queens, NY.
He is a member of the American
Academy of Cosmetic Dentistry, the
International College of Oral Implantology, the
American
Academy of Osseointegration, and the Academy of General Dentistry. He has held
staff appointments at Nassau County
Medical Center
and Long Beach Hospital. Dr. Margolies has
published articles and given lectures, nationally and
internationally, on the relationship between aesthetics and
function in comprehensive and implant dentistry. He
maintains a private practice, with offices in
Hewlett, New York,
and Manhattan,
focusing on comprehensive dentistry, oral aesthetics, and dental
implants. Dr. Margolies conducts seminars through the
Institute for Predictable Restorative Dentistry.
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course
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16 CE Credit
