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Full Mouth Reconstruction



Jerry Ragle, CDT

From start to Finish.....

Full mouth reconstruction can be somewhat complicated, but as with any large case a well thought out plan from the start will take most of those complications out of the equation.  This patient had been without a solid bit for several years.  While missing teeth, occlusion and function somehow they managed...  now it is time to restablish their occlusion, replace crowns where there are none and replace crowns where there were some and untimatley establish group here we go!

Options for Temps:  

  1.  Diagnostic models with putty matrix or impression for chairside temps.

  2. Lab temps milled or printed from diagnostics.

Lab Temp Workflow:

 Stage 1: Initial Temps- Create temps on missing previously prepped 6-10 and 20 and 21.  Create "shell" temps for the replacement of current crowns on 11-30 and 22-27 and 28-29.  Once all temps are completed they are sent for placement.

Stage 2:  Placement and Bite- 

  • Place new temps to pre-existing preps, 6-10 and 20 and 21.  Check occlusion, make adjustments as needed to balance occlusion with pre-existing restorations 11-14, 22-27 and 28 and 29.   

  • Remove 11-14, finalize preexisting preparations on those teeth. 

NOTE: 6-10 will now hold the vertical.

  • Reline and place the replacement "shell" temps on 11-14 making occlusal adjustments as needed. 

NOTE: 6-10, 20, 21 and 11-14 will hold the vertical.

  • Remove 22-27, finalize preexisting preparations on those teeth.

  • Reline and place the replacement "shell" temps on 22-27 making occlusal adjustments as needed.  

  • Remove 28, 29, finalize preexisting preparations on those teeth.

  • Reline and place the replacement "shell" temps on 28, 29 making occlusal adjustments as needed.

Stage 3: Scans:

  • Scan U/L with all temps in place as separate arches, then together for the bite scan. That becomes the needed pre-op. 

VERY IMPORTANT: Scan palate, as well all tissue, so landmarks can be used when we are aligning files otherwise files will not align and rescans will be needed. 

  • Once completed remove anterior 6-10 and lower 20, 21.  Making final adjustments to those pre-existing preparations.  

  • While those temps are off scan U/L once again along with a bite scan. Take a Blu-Mousse bite across the arch just as a back-up.  Basically, this is a back-up set of files since diagnostics were completed on these teeth.

  • Once completion of the back-up scans, remove the rest of remaining temps, scan upper arch preps and then lower arch preps. These become our working scans and will be virtually articulated using the previous scan as noted above.

Remember: The palatal scan and tissue are needed and important for alignment landmarks.

Send all scans via the portal


PDF Download Link w photos

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