TrueTeeth Surgical Reference Guide

TrueTeeth Surgical Reference Guide

VISIT ONE: INITIAL CONSULTATION WITH SURGEON

1. PATIENT INTERVIEW

-Identify chief complaint

-How can I help you?

2. CASE SELECTION AND DOCTOR SCRIPT

The most ideal group of patients that can benefit from the TRUETEETH concept can be categorized into two broad groups:

a). The dentate patient with severely compromised teeth or what we call the “dentally exhausted patient”.

b). The edentulous patient who is unable to “cope and adapt” to a removable format.

3. SMILE ANALYSIS, LOCATION OF THE POTENTIAL PROSTHETIC-TISSUE JUNCTION, AND IDENTIFICATION OF THE VERTICAL MAXILLARY EXCESS PATIENT

a). The prosthetic-gingiva junction zone needs to be clearly established for all patients seeking treatment in the maxilla.

b). In addition, special attention is needed to identify the “vertical maxillary excess patient” meaning those patients with especially “long lower facial thirds that will display as much as 5mm of gingiva apical to the gingival margin of maxillary anterior teeth.”

4. CLINICAL EXAMINATION

a). Doctor will perform a basic cursory intraoral examination to assess general state of health or degree of dental disease

b). This general examination reveals an indication or contraindication for the TRUETEEETH approach.

5. CBCT ANALYSIS

a). Includes 3D analysis of potential implant placement, A-P spread of implants, and the possibility for extraction/immediate placement/immediate load.

b). Clinicians are encouraged to measure remaining clinical crown height (plus exposed root), bone width/height for potential implant placement, and degree of alveolectomy that may or may not be needed.

6. ASSESSMENT OF VERTICAL DIMENSION OF OCCLUSION AND RESTORATIVE SPACE CONSIDERATIONS

a). VDO assessment with a lip competency approach takes less than one minute.

b). When VDO is exceeded, patient will have difficulty with “lip approximation at rest”.

c). Minimal vertical restorative space requirements:

Fixed Hybrid Abutment-level 13-15mm

Fixed Monolithic Zirconia Abutment-level 10-12mm

d).Surgical protocols should vary from a “material science” perspective:.

Hybrid design-implant exit point should not be within the confines of a denture tooth (screw-access should be within the denture base).

For monolithic zirconia- the screw access can be within the confines of the prosthetic tooth

7. REVIEW OF MEDICOLEGAL INFORMED CONSENT OPTIONS

a). Discuss advantages/disadvantages of fixed vs removable formats.

b). Introduce fee schedule for TRUETEETH, which is needed for case acceptance and case progression.

8. REFERRAL AND COMMUNICATION WITH RESTORATIVE COLLEAGUE

a). Surgeon to discuss general findings with restorative dentist.

b). Need to clearly identify the patient as a TrueTeeth candidate so can proceed with diagnostic work-up.