Treatment Planning

In recent years treatment planning options have become more sophisticated and patient expectations have risen. We will be happy to assist you in the treatment planning of your implant or conventional restorative cases. Please allow us to be a part of your restorative team. Below are some guidelines to get started.

Study models for treatment planning and how to make them work for you.

When making study models for treatment planning it is important to record the following:

  1. Retromolar pads
  2. Maxillary tuberosities and hamular notches
  3. All labial vestibules

Models must be articulated. Please send a bite if models cannot be hand articulated.

Three things happen as teeth wear.

  1. Vertical is reduced.
  2. Vertical is not reduced. As teeth wear occlusally, the bone follows the teeth and vertical does not change.
  3. Combination of the first two. The occlusal wear happens at a faster rate than the bone can follow resulting in a reduced vertical.

Maxillary anterior teeth are 22mm from the labial vestibule to the incisal edge. Mandibular teeth are 18mm from the labial vestibule to the incisal edge. By measuring from the vestibule to the incisal edge we can tell how much vertical the patient has lost if any. This is key for treatment planning. Once we know the vertical for restoring the anterior teeth it is now time to decide the proper posterior plane of occlusion.

To identify the posterior plane of occlusion we can intersect a line from the proper lower anterior height to the retromolar pads. The line should intersect the retromolar pad at 2/3 their height.