North Texas Dentistry Volume 5 Issue 3 | Page 13

Minimally Invasive Preservation of natural tooth structure is of the utmost importance. Every clinician should consider this when creating any treatment plan, whether for one tooth or for full mouth rehabilitation. One of the most incredible features of this treatment is that, with the exception of replacing three old crowns with new e.max crowns (Dan O’Rourke, CDT), Laurie’s mouth was restored with absolutely no tooth structure being ground down or permanently altered. Dr. Stewart has been rejuvenating mouths in this manner since 2001, and many cases have required little to no maintenance over the years. Low maintenance and minimal changes to tooth structures are the features of Dr. Stewart’s rejuvenation treatments that Laurie, like many other patients, has found so appealing. C2O Therapy Physical therapy of her TMJ was initiated with C2O (Condylar Centering Orthotic) therapy. This is a maxillary hard acrylic that creates a biologic anterior proprioceptive guiding environment in the stomatognathic system. It was regularly and methodically adjusted on a weekly basis utilizing dead soft shims. It is important to note that all of her symptoms – jaw pain, muscle tension and headaches – subsided completely during orthotic therapy. The condylar repositioning was tracked with the MCD Instrument (ad2usa.com) to verify complete seating of the condyles. When the C2O therapy was completed and verification of the seated condyles was made, a hinge-axis recording was taken along with a final centric open bite. Vertical dimension jigs were built off of these models and the patient was allowed to wear the jigs as facial appearance and overall comfort was observed and recorded for each jig. Once the vertical dimension was established, a final diagnostic wax up was completed by Dan O’Rourke, CDT on centric-relation mounted study models. Centric stops and anterior guidance were established in the wax up. Treatment By utilizing Adhesive Composite Rejuvenation techniques as taught by the faculty at The Texas Center for Occlusal Studies (TXCOS), the wax up was predictably and carefully duplicated in the mouth to within 10 microns of accuracy creating a harmonious anterior proprioceptive guided chewing system at the improved vertical dimension of occlusion. The composite used was a combination of Filtek Supreme (3M) and G-aenial Universal Flow (GC America). Both of these composites are nanohybrids with excellent wear resistance and polishability. The final results are both functional and esthetic. Note the changes, not only in the teeth themselves, but in the face and eyes of the patient. By restoring the occlusion to a stable condylar position in centric relation and at a proper vertical dimension, not only do the teeth look great but the facial muscles as well as the muscles of mastication are relaxed and functioning harmoniously with one another. The occlusion is ideal, so the pressure on the teeth is minimal resulting in longterm stability and esthetics. Laurie feels great and loves the way her smile and entire face have been transformed. This is typical of the results that we see at The Texas Center. 6011 Morriss Rd. Flower Mound, TX 75028 (855) 539-4040 www.northtexasdentistry.com www.TXCOS.com | NORTH TEXAS DENTISTRY 13