Prosthodontics

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• Measurable Outcomes e.g., total number of hours dedicated to the Discipline of Removable Pros Dentistry, type and number of cases.

  1. Total Number of Hours: 50

  2. Full Arches: 3, 1 in progress

  3. Partial Arches: 1, 1 in progress

• Describe one complete and one partial case that you treated, what went well and what was unexpected. What did you learn from the case.

  1. My grandmother, second case, was my first case and she has progressing dementia. She was the hardest patient that I had to work on in the clinic. I had to literally hold her mouth open during impressions so that the material did not set. In reflection, there is a good possibility that many denture patients could have dementia or some form of it and having patience is ultimately the most important thing that we can have as clinicians.

  2. My partial case had to start over from the delivery appointment because the patient's teeth shifted. The patient was in between jobs and not able to come into his appointments. That was incredibly heartbreaking but it was a great opportunity to redo the steps confidently. And the patient could not be happier with his partial.
     

• Describe the variety of clinical situations that you encountered, things that you learned and did to accomplish the treatment even under adverse circumstances.

  1. Our denture block patient was a 42-year-old woman that had no dentures and was edentulous. She had been edentulous without any dentures for about 15 years and her VDO had completely collapsed. Dr. Hoover helped open her up to her appropriate VDO and her face looked so much more full and she looked a lot better. I learned how drastic a proper VDR+VDO can be on someones appearance.

  2. My grandmother had worn full dentures for 40 years but lost her upper denture when she fell. Nonetheless, we were able to use her existing lower denture for guidance in terms of tooth shade and size. I learned that dentures at best can have mixed reviews from patients but if the patient likes what they have, we should try hard to replicate that in their new set.

  3. My near full extraction case (19 extractions) taught me the most of any case that I saw in dental school. I worked with Dr. Hoover, Dr. Curtis, and Dr. LaBarre extensively, whilst also reading various textbook and literature sources as to how best serve the patient. Working with each of the faculty I saw how each of them have a unique style to how they approach dentistry and how there are often times many ways to the many different answers of how to proceed.

  4. My last case only got to the second step. The patient has a back issue that does not allow him to recline in the chair, so for that case I learned how to adapt to my patient's physical needs and limitations.

• Self-assessment of how you performed on the Removable Pros Competency.

  1. As for the competency I only got to the initial impressions and final impressions for the full/partial case. However, I really pushed myself that day by scheduling the patient for back to back appointments, 1 in the morning for the initials and 1 in the afternoon for the finals. The case is well on its way.

• Describe the percentage of your cases that were completed largely independently, about how many times did you require a significant amount of faculty intervention to get things done.

  1. The case that I have not completed I have worked solely by myself.

  2. The case with the Full/Partial that is completed, the third case, I received 25% help

  3. Dr. LaBarre watched carefully over me with my grandmother, and while she does not remember much, she reminds herself everyday of how much she loves her dentures.

• Why you feel that you are competent in the discipline of Removable Pros Dentistry.

  1. Dr. Hoover and Dr. LaBarre to their credit are so insistent on following the steps properly. CR does not make sense when you first learn it, especially when you have lived dentate your whole life. But when a patient is not able to open or speak properly because your VDO is off, a lot of things make sense. Moreover, removable is a pure step following process. That is not to minimize it but it really does come back to hurt you if you do not follow the steps, i.e., without a good initial, you cannot accurately study your models and cannot get good custom trays. Without a good final, the patient will hate their dentures because they just do not fit. And if they do not look esthetic then you are going to have to do it again. I have seen that removable is arguably the most rewarding field because it is so life-changing as you can see above. The ability to partake in this process is something that I am ready for.