Full mouth rehabilitation – CRITICAL THINKING

Another example of the
simplicity possible in creating a Clinical eChronicle. More detailed explanation
of the procedure, the sophistication can be expanded upon by having an
instructive template and the graphic inclusion in this case is aggregate, it
can be simplified and standardized based upon the sequence of treatment, lab
inclusion images, radiographs, video and animations.  It is an excellent documentation record and
highly instructive for the readership. The KEY CONCEPT of this initiative is

Second case from Dr. Garcia:

We finished this case this
week.  This is a gentleman who lives in
Brasil, worksin the oil industry and travels through Houston from time to
time.  Thank God for oil and gas!

A nice gentleman to work
with, very low maintenance and appreciative. 
We started with our usual records appt and K7 workup, TENS and nm
bite.  He needed some teeth extracted in
the maxilla and some missing teeth replaced in the mandible in order to
establish a stable bite – at least first molar occlusion :-,,).  Our own Dr. Rick Kline placed the implants at
29, 30 and 18. He had his ext and implants placed under IV sedation.  Fortunately and amazingly (to me) he did not
need any bone grafting. I placed his bonded orthotics right after the surgery –
same day.  He healed and stabilized for 3
months. Then uncovery and fixture level impressions for custom Ti
abutments.  Two weeks of tissue healing-
the uncovering was done with a punch and not flapped hence the 2 week healing
vs. 4 weeks if it had been flapped.

Then abut ins and prep so it
is all a full arch C & B impression. 
I find that much easier than doing implant transfers and teeth at the
same time. And I HATE open tray impressions- as in I almost NEVER do them.  Honestly, I don’t see a need for open tray
impressions.   This time it was not a quick
turnaround.  We gave Bob 5 days to do it
:-).  This is an all eMax case by Bob
Clark and Williams Dental lab. They did everything from the initial wax ups,
custom Ti abutments, eMax, etc. He was usually a pretty quiet guy.  But, at the 24 hr follow up (all post op pics
are 24 hrs post op) he said he loved his new smile.  Sweet music to my ears.  Never expected it from this guy, but always

Here is the
rest of the information regarding that fm rehab I posted yesterday that
involved 3 implants.  As I mentioned I do
not yet have a post op CT, but you can see the bone situation and proposed tx
plan from the pre CT.  We only placed
implants at 19, 29 and 30.  NO implnat
was placed at 18- we did not need to. Also, please remember that the virtual tx
plan is subject to change at the time of sx. 
Reality vs. virtuality :-).  In
this case that means that the placements were probably a little different than
the virtual plan, but close.

comps after rsz[4].jpg

implant comps[1].jpg


Arturo R. García D.M.D.

Smile Texas

4665 Sweetwater Blvd.

Ste 450

Sugar Land, TX 77479



By way of example, picked this discussion on rehabilitation from a very talented Ontario Dentist, Stephen Phelan; wonderful example of CRITICAL THINKING!

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