The 4 Elements of Predictable Dentistry
Posted by: Dr. Neeraj Khanna
The necessary elements for the treatment planning process.
Let's begin from the basics of what this means. Anything that we teach you that's predictable starts with a four-stage process.
That first step is the complete exam, the second step is the treatment planning process, the third step is provisionalizing the restorations, and the final step is the delivery of the final restorations. I'd like to go through each one of those with you briefly to explain the importance of how each one is related to the other.
1. The Complete Exam
The complete exam involves understanding your patient's joint position, muscles, and how the teeth relate to each other. This examination is very comprehensive. It needs dedication of time and effort, but it also determines whether you're dealing with a stable or unstable occlusion.
In most cases, most of your patients will be an unstable situation. Having said that, that leads you into creating diagnostic records. Part of that process requires perfect impressions, a perfect facebow, accurate diagnostic photographs and, more importantly, an accurate centric relation bite.
That process leads you into the next step which is the treatment planning process.
2. Treatment Planning
Once you've got verification of accurate models, then it's time to go through the checklists The Dawson Academy provide. I recommend that you don't skip any steps on either the 2-Dimensional or the 3-Dimensional checklist.
At the end of that process, regardless of how simple or complicated the case is, you're going to fulfill the five requirements of a stable occlusion. Once you've verified this on the articulator that will now give you the templates needed to provisionalize your restorations. That will take us into the third step.
3. Provisional Restorations
It'll give you an idea of how to prep your teeth. It will also give you an idea to duplicate where that incisal edge position is going to be, whether it's on the lower anterior teeth or, more importantly, the upper anterior teeth.
The provisional stage, which is the third step, allows you to predictably design your restorations and during this process we want our patient to test-drive your restorations. Have them come back to your practice, adjust anything that's necessary related to phonetics, function, and esthetics of course.
Once we get the approved provisionals from our patient, that is the time to duplicate that and make sure we have proper communication with our lab technicians. You can also send certain stents along with your impressions of your provisionals and that gives permission to the technician to start beginning the final restorations.
4. Final Restorations
The last step which is the delivery of the final restorations should really duplicate, if not mimic, the provisional stage. That is the beauty of the predictability and that is probably the most exciting part of this whole process is that when you complete the case, there's very little adjusting necessary because you've already planned out everything ahead of time in the provisionals.
So in order to do predictable dentistry, we recommend those four steps but each of those four steps is related to each other but it all starts with a complete, thorough examination. I hope this makes sense and I hope that you are practicing complete dentistry and using all of those four elements.
To learn more about our treating planning process and the pathway to predictable, successful dentistry, sign up for the Functional Occlusion - From TMJ to Smile Design course.
Photo by Makarios Tang on Unsplash