I require help for this case

[smilesbyveeren@gmail.com]

Patient is a 53 year old male.     

Medical history is non-contributory.

Fairly conscious about oral hygiene.

Lower left first molar will be replaced by implant.

      

 RCT in lower anteriors were done before but were not satisfactory so I had to re-do them. I expect a little bit of leakage of endodontic sealer in the lower right central incisors to be resorbed .

 

As would be obvious post and cores will be required for the lower anteriors.

      

Crown is required lower right first molar.

As the images shown there has been severe attrition in the patients dentition and the vertical height is reduced.

Now should I

·        Start building lower anteriors without raising the vertical dimension or

·        Should I raise the vertical dimension and then start restoring the lower anteriors.

 

If the vertical dimension has to be raised how should I go about it.

Any help would be greatly appreciated

 

Thanks in advance for all the inputs,

 

Regards,

 

Dr. Veerendra Darakh

        

[smilesbyveeren@gmail.com]

 The OPG is attached to this post

        

[drmithila]

 Since the posteriors are present and in occlusion i dont think bite raising is required and what vertical dimension is lost should be restored by the crowns placed on the anteriors

Do correct me if this idea sounds inappropriate or if i have not been able to gauge the need of raising the bite

        

[drsushant]

In my view, the bite has to be raised because the vertical dimension might have been reduced due to gradual attrition..and moreover if we try to give crowns in the anteriors without raising the bite, it will cause an open posterior bite.

        

[drsushant]

The OPG also shows the lower right 6 requiring retreatment before giving a crown. If this tooth is not treated and goes for extraction later, maximum masticatory load will come on the implant which is not advisable.

        

[smilesbyveeren@gmail.com]

 Since the posteriors are present and in occlusion i dont think bite raising is required and what vertical dimension is lost should be restored by the crowns placed on the anteriors

Do correct me if this idea sounds inappropriate or if i have not been able to gauge the need of raising the bite

there is hardly any space for crowns in the lower anteriors. Bite raising will be required. If I put crowns without bite raising the crowns on the lower anteriors will come out.

Regards,

Veerendra Darakh

        

[Drsumitra]

 What method will you follow to raise the bite?

        

[Drsumitra]

 

        

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