{"id":465,"date":"2012-03-19T01:32:05","date_gmt":"2012-03-19T06:32:05","guid":{"rendered":"http:\/\/allisonwatts.com\/blog\/?p=465"},"modified":"2020-12-24T05:51:09","modified_gmt":"2020-12-24T11:51:09","slug":"funtional-diagnosis-treatment-planning","status":"publish","type":"post","link":"https:\/\/allisonwatts.com\/funtional-diagnosis-treatment-planning\/","title":{"rendered":"Functional Diagnosis and Treatment Planning"},"content":{"rendered":"
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Functional Diagnosis and Treatment Planning<\/span><\/b><\/span><\/span><\/div>\n
by Allison Watts, DDS<\/span><\/i><\/b><\/span><\/span><\/div>\n
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For the last several Mondays, we have been walking through the steps of a  full – mouth reconstruction.<\/b>  I have enjoyed putting all the pieces of this complex process together and simplifying them to make them easy to implement. That is my goal here. The trick is whether it comes across in print and whether I’ve included enough or too much information… <\/span><\/span><\/div>\n
Here’s a review of what we’ve covered so far: <\/b><\/span><\/span><\/div>\n
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  1. Phone call\/First encounter<\/b><\/a><\/span><\/span><\/li>\n
  2. NP experience\/First appointment<\/b><\/a><\/span><\/span><\/li>\n
  3. Data collection\/Records<\/b><\/a><\/span><\/span><\/li>\n
  4. Treatment planning and sequencing<\/b><\/a><\/span><\/span><\/li>\n
  5. Setting fees <\/b><\/a>– <\/b>Just a reminder that much of fee-setting is mindset—how comfortable are we with the value of what we do and do we believe that what we do is a commodity or a highly valuable service (the more training and skill we have, the more valuable).<\/span><\/span><\/li>\n
  6. Last week, we took a closer look at diagnosing and treatment planning esthetics. <\/i><\/b><\/a><\/span><\/span><\/li>\n
  7. This week, we are going to focus on Function:<\/i><\/b><\/span><\/span><\/li>\n<\/ol>\n
    Occlusion is such a big part of the long-term predictability and stability of what we do.<\/strong> Completing a comprehensive evaluation of the TMJ, muscles and the occlusion is essential to evaluating and treating complex cases. Most of what I am sharing, I learned from Pankey, Spear and Dawson, though there are pieces from other teachers. <\/span><\/span><\/div>\n
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    Remember, our occlusal diagnosis comes from information we get from the examination and records.  We want to gather information first, identify the condition (make a diagnosis), decide on the desired outcomes and then decide how we are going to help the patient get to the desired outcome (treatment plan and sequence).<\/span><\/span><\/div>\n
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    Before we make create the occlusal treatment plan and sequence, we need to  have an excellent esthetic diagnosis and treatment plan that includes where we want the teeth to be esthetically. Through esthetics you can figure out where the upper and lower teeth look good in the face, but then you have to figure out how they are going to fit together for proper function—function that works well for the patient and helps the dentistry last as long as possible. We want to know where the envelope of function is and make sure we put the teeth in harmony with it.<\/span><\/span><\/div>\n
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    During the functional exam, there are many things we want to figure out:<\/strong><\/span><\/span><\/div>\n
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    1. Is the occlusion physiologic or pathologic?<\/span><\/span><\/div>\n
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    2. Does the occlusion need to be altered (Is it pathologic)?<\/span><\/span><\/div>\n
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    3. Am I doing dentistry that will destabilize the occlusion? The answer is definitely yes in a full-mouth reconstruction, but we can destabilize the occlusion by altering one tooth if it’s a guiding tooth or first contact!<\/span><\/span><\/div>\n
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    4. How do we design the occlusion so that it works?<\/span><\/span><\/div>\n
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    It’s important to analyze the current occlusion to see if it’s working or if it’s not. Often, when I’m doing large cases, the occlusion has not been working well and that is one of the reasons they need a lot of dentistry. To analyze the current occlusion, we need:<\/span><\/span><\/div>\n
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    a. Exam <\/b>– If you’d like copies of my occlusal, TMJ, muscle exam, let me know.<\/a><\/span><\/span><\/div>\n
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    b. Photos <\/b>– If you’d like ideas on photo analysis, let me know<\/a>. <\/span><\/span><\/div>\n
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    c. <\/span>Mounted models<\/b> – We get so much information from mounted models. From esthetic information to occlusal information, most cases I treat require and benefit greatly from mounted models. Full mouth rehabilitation definitely requires mounted models. <\/span><\/span><\/div>\n
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    To properly mount models, you need:<\/strong><\/span><\/span><\/div>\n
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