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Treatment of a Failing Dentition Part 1: Diagnosis and Prognosis
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This video will allow the viewer to observe the first appointment the patient and dentist meet and the importance of developing a mutual understanding of patient expectations and dentist methods of obtaining vital information prior to accepting to perform the dental procedures. A series of questions followed by an examination will allow a thorough assessment and eliminate any misconceptions that many times occurs for first time patients having total mouth extractions. The evaluation highlights will be demonstrated as it actually happens from a list of questions fol-lowed by an esthetic analysis, radiograph review, patients existing occlusal vertical dimension compared to rest vertical dimension and final discussion with patient before committing to treatment. Please join us for Part I.


Learning Objectives:

  1. Implement making facial recordings to determine the esthetic & functional spaces.
  2. Ask predetermined questions at the assessment to improve patient dentist relationship.
  3. Understand and inform patient whether a fixed, hybrid or stud retention prosthesis is optimal
  4. Educating patient at the exam and or consultation appointment can prevent failures
  5. Determining the outcome before committing to treating any patient.


The treatment options available for a patient with non-restorable dentition with closed vertical occlusion combined with a moderate skeletal class 3 relationship are conventional complete dentures, implant-supported overdentures (removable), fixed implant-supported complete dentures, and fixed metal-ceramic implant-supported restorations.

Choosing the appropriate procedures whether bone trim, orthognathic surgery and or implant therapy is crucial to plan before edentulating the patient. Also of great importance is  pre-determination of the final appearance based on what the patient presents with and what can be accomplished under those circum-stances. The decision process to restore a patient with implant fixed or removable restorations should be determined by evaluating various parameters such as:

  1. Overall patient  general health
  2. Facial asymmetry
  3. Facial contour as either void or full
  4. Lip-line & lip support
  5. Quality and quantity of hard- and soft tissues
  6. The maxilla-mandibular relationship
  7. Oral hygiene traits
  8. Existing occlusal and skeletal relationship
  9. Patient understands and accepts all risk
  10. Patient financially able to have procedure performed


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