Watch Preview of Spear Seminar – Treating the Worn Dentition

Watch Preview of Spear Seminar – Treating the Worn Dentition

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So the first part of the course is all about
the different etiologies of tooth wear. Because, in reality, tooth wear is not all created
equal. There is some tooth wear that looks horrendous and yet is incredibly predictable
to treat. There’s other tooth wear that might not look as horrendous but might be
highly susceptible to breaking porcelain. One of the biggest problems with tooth wear
and it’s why it’s so confusing to dentists is as teeth wear, the teeth erupt to maintain
their occlusal contact. Either that or the patient loses vertical dimension of their
occlusion. So when you have a patient that has a lot of tooth wear, their teeth aren’t
in the right place. And, yet, the dentist who’s looking at them wants to try and restore
them where they are. Doesn’t work well. So we go through etiologies, which helps with
prognosis, then we go through patterns. Then we go through, alright so I’m going to get
the teeth in the right place. Now I’m going to restore this patient. How do I know it’s
going to work? So we spend a lot of time on what the restorations need to look like in
the end to end position and the pathway position. We spend a lot of time talking about vertical
dimension. Can you open it and how much can you open it? What happens after you open it?
Because in some of these wear cases you do need to open the bite quite a bit. And then,
the other big problem with wear cases is some of these teeth get really short. Do you crown
lengthen the tooth? Do you do root canals? Do you do post cores? What do you do to be
able to restore these teeth? And then, day two, and I think one of the most beneficial
parts to that course, is the morning, they are all case after case after case, start
to finish. And they’re all different. They’re all chosen because they have a different kind
of wear and a different pattern. And we walk through the treatment planning step-by-step
for each of the different cases. What I discover is dentists love being able to see a case
go start to finish and they love being able to see a case that they have sitting in their
office. Because most of these people have these cases sitting in their office, on models
sitting on their desk and they just don’t know what to do with them. And then, in the
afternoon of the second day, we actually spend a fair amount of time on implants in people
who grind their teeth. Because the implants in people who that grind their teeth have
a much higher risk factor for fractured porcelain because the implants are more rigid than teeth.
So you talk about how do you treatment plan around that. What does the occlusion look
like when you know that you have to put implants in these people? How do you minimize the risk
of broken porcelain or abutment failure? We also talk about material selection in people
that grind their teeth. If I’m going to restore an implant or natural teeth, I need
stronger materials. So what do I use? Finally, we end the second day with Appliances for
People Who Grind Their Teeth. What kind of a bite appliance do I use if my patient grinds
their teeth to protect porcelain, to protect natural tooth structure? So it’s a really
fun seminar to be honest. It’s really fun! I think it’s very comprehensive going from
the etiology, through how you manage the occlusion, to showing the cases, to showing things about
implants and materials and appliances. That’s, essentially, the two days.

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