dr don reid speaker packet

DDOONNAALLDD NN.. RREEIIDD,, DDDDSS,, FFIICCOOII

Would you like to develop the skills and understanding to confidently treat

the most complicated occlusions?

Dr. Don Reid lectures internationally on the diagnosis, evaluation and treatment of bite disorders, facially generated treatment planning and the health-centered Volitional practice. He also teaches hands-on programs for treating the worn dentition. Dr. Reid’s unique range of experiences combined with a passion for resolving occlusion confusion make him an exceptional choice for your next meeting! Choose from one of Dr. Reid’s popular presentations below… or ask about customizing a presentation to meet your group’s needs.

Dr. Reid’s informative and enthusiastic presentations will make your next meeting a hit!

RREESSOOLLVVIINNGG OOCCCCLLUUSSIIOONN CCOONNFFUUSSIIOONN This course will help you see how simple occlusion understanding is when broken down into its bare elements of teeth, bones, muscles and a joint! You’ll gain confidence to solve bite problems and use the same principles to predict successful outcomes whether restoring single teeth or full arches.

FFAACCIIAALLLLYY GGEENNEERRAATTEEDD TTRREEAATTMMEENNTT PPLLAANNSS Acquire a fresh and simplified understanding to treatment plan what people really need and want. Learn why diagnostic principles around occlusion and esthetics are essential to achieve the step-by-step system of planning required for long term clinical success and patient satisfaction.

TTMMJJ CCUURREEDD:: FIXING THE BITE IS THE ANSWER Join Dr. Reid for a course that will help you see for yourself why muscles hurt, jaws ache and pop, and teeth are unnecessarily damaged because of an improper bite. Various treatment options to solve TMJ and bite issues will be explored so you will understand the best choice for you and your patients.

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WWW.DRDONREID.COM [email protected]

http://www.tahoedentalartistry.com/

mailto:[email protected]

RREESSOOLLVVIINNGG OOCCCCLLUUSSIIOONN CCOONNFFUUSSIIOONN

If the destructive forces from occlusion scare you, you’re not alone! Exposure to complicated techniques and equipment, a profusion of philosophies, and meaningless rules intensifies confusion which prevents otherwise capable dentists from performing complex dentistry. This course will help you see how simple occlusion understanding is when broken down into its bare elements of teeth, bones, muscles

and a joint! You’ll gain confidence to solve bite problems and use the same principles to predict successful outcomes whether restoring single teeth or full arches. PARTICIPANTS WILL LEARN: Recognize the signs and symptoms of Occlusal Disease and how to discuss them with a patient at the

examination. When altering an existing occlusion makes sense. The benefits of border positions in the front and back of the

mandible. How teeth contacts cause TMD. A simple method to differentiate intra and extra articular

disorders. When an occlusion demonstrates orthopedic stability. How to alter tooth form to ensure restorative success. What TMJ noises look like in 3D. How and when to change Vertical Dimension. Learn to use appliances to locate, register and capture

excellent bite records. Several techniques to capture centric relation bite records. What to do and say when treating a severely compromised

occlusion .

This course illuminates every cause, effect and treatment of destructive bite forces. Dr Reid’s passionate style utilizes theory, 3-D animations, and clinical examples to help attendees gain confidence / skills in this controversial arena. As a General Practitioner that treated over two thousand destructive occlusions, Dr Reid conveys relevant information that can be used on Monday morning.

DDOONNAALLDD RREEIIDD,, DDDDSS


((553300)) 558877--99556600

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http://youtu.be/dPt3xtJYFtE

FFAACCIIAALLLLYY GGEENNEERRAATTEEDD TTRREEAATTMMEENNTT PPLLAANNSS

Daily chair-side dentistry is solely dependent on the skills of the practitioner to evaluate, diagnose and present dentistry. Unfortunately, most graduates are unskilled to address both occlusion and esthetics and consequently offer fine dentistry but incomplete treatment plans. Subsequently, patients don’t receive the benefits of more beautiful smiles and restorative dentistry that

withstands the test of time. The practice suffers from the ‘busyness’ created by single tooth dentistry instead of relaxing and more profitable full arch care. Dr. Reid has treated over two thousand destructive occlusions in his general practice. In this course, he presents the knowledge and skills that weren’t emphasized in dental school so you will acquire a fresh and simplified understanding to develop the confidence to treatment plan what people really need and want. Learn why diagnostic principles around occlusion and esthetics are essential to achieve the step-by-step system of planning required for long term clinical success and patient satisfaction. In addition, the concepts of how to present your findings to the patient are covered in detail. PARTICIPANTS WILL LEARN: Which photographs are necessary for patient education,

comprehensive treatment planning and lab communication. How and why a composite mock-up can be useful for patient,

lab, and surgical communication. The key steps in treatment planning and why it is important

that they be completed in a specific order . Why treatment planning and treatment sequencing must be

separated into two processes to come up with a plan that integrates esthetics and occlusion .

To develop a treatment plan that optimizes esthetics while providing optimal function, even in patients with difficult wear problems .

The common patterns of tooth position changes with tooth wear, how they affect occlusion and esthetics, and how to correct them.

How to safely and logically discuss treatment with your existing patients.

Upgradeable Dentistry - When and how phasing can be done to help patients who cannot financially manage a large or complex case but have the desire and resources to begin.



((553300)) 558877--99556600





TTMMJJ CCUURREEDD

FIXING THE BITE IS THE ANSWER

If you have not personally experienced a TMJ problem, chances are you know people who have. The symptoms include debilitating headaches, jaw opening issues, loose, sore and fracturing teeth and excess grinding and clenching of the teeth. In the past, many TMJ sufferers underwent surgery or massive reconstruction while a minimally invasive solution was ignored.

Most dental school graduates are confused over the workings of this unique joint. Join Dr. Reid for a course that will help you see for yourself why muscles hurt, jaws ache and pop, and teeth are unnecessarily damaged because of an improper bite. We’ll explore and discuss various treatment options to solve TMJ and bite issues so you will understand the best choice for you and your patients. PARTICIPANTS WILL LEARN: The bare bone elements of a stable, comfortable and healthy

bite… a unique view of the jaw bones, joints, teeth and muscles.

A simple, predictable and practice building diagnostic tool to help over 90% of TMJ sufferers learn they have healthy joints and a bite-muscle problem!

Improper bites are either developed from birth, a trauma to the jaws, or after extensive dentistry or orthodontics. The cause and effect of all causes will be well understood.

Treatments to solve TMJ or bite issues vary. Bite balancing or equilibration, oral devices (splints), restorative dentistry, as well as orthodontic intervention will be discussed .

THE ‘HEADACHE DILEMMA’ SOLVED

The title, format, and content of Dr. Reid’s presentations can be adjusted to fit the needs of your audience. This course can also be customized for special groups, such as:

woman dental staff hygiene …or the entire team!



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DDOONNAALLDD NN.. RREEIIDD,, DDDDSS,, FFIICCOOII

I was one of those very confused dentists who lacked the skills and understanding to confidently treat their patients due to the confusion around occlusion. The patients are usually healthy periodontally with minimal or no caries, yet they are breaking-grinding-loosening- and causing pain in their teeth that goes largely ignored or they are treated for the effects and not the cause of destructive bite forces. When patients have an ‘Aha’ moment in understanding their problems, they are fans for life and enthusiastically refer their family and friends. Based upon 15 years of experience speaking on this topic, I anticipate my

audience will have an ‘Aha’ moment themselves when the see the simplicity of this complex masticatory system. Past participants say: “They can’t wait to get back to work on Monday morning.”

Dr. Don Reid lectures internationally on the diagnosis, evaluation and treatment of bite disorders, facially generated treatment planning and the health-centered Volitional practice. He also teaches hands-on programs for complete reconstructive dentistry as well as advises colleagues with clinical dilemmas. He is published in leading dental journals and magazines. Dr. Reid is the creator of BiteFX software animations which depict the destructive effects caused by malocclusions or temporal mandibular disorders. Dr. Peter Dawson’s Center, as well as universities and private institutions around the globe, are using Dr. Reid’s software to enhance student’s comprehension of the human masticatory system. Dr. Reid is a fellow of the International Congress of Oral Implantology, graduate of the Dawson Center for Advanced Dental Studies, Misch International Implant Institute and is a both pioneer and a founding Father of the Academy of Microscope Enhanced Dentistry. He is a long standing member of the American and California Dental Associations, Dental Organization for Conscious Sedation and the American Academy of Cosmetic Dentistry.


((553300)) 558877--99556600


http://www.bitefx.com/

http://www.icoi.org/

http://www.icoi.org/

http://www.dawsoncenter.com/

http://www.dawsoncenter.com/

http://www.misch.com/

http://www.microscopedentistry.com/

http://www.microscopedentistry.com/

http://www.docseducation.com/

http://www.aacd.com/




PPRREEVVIIOOUUSS PPRREESSEENNTTAATTIIOONNSS // TTEESSTTIIMMOONNIIAALLSS

PARTIAL LISTING OF PREVIOUS PRESENTATIONS Seattle WAGD mastermind group

Smile Vision occlusion Webinar

Dawson Center for Advanced Dental Studies

Academy of Microscope Enhanced Dentistry

Loma Linda Study Club: Occlusion Centered Dentistry- A global opportunity

Omer Reed Napilli Seminars

The Group at Cox

“Ever since I first met Dr. Reid I have been impressed with his passion for practicing excellent dentistry and communicating the concepts and importance of occlusion to his colleagues. My own teaching has benefited greatly from the animations he pioneered. If you want an exciting, motivating speaker who delivers essential knowledge with passion, backed up by the experience of a most successful practice, I have no hesitation in recommending Dr. Reid to you.”

Ross Nash, DDS; Founder. The Nash Institute “I’ve literally taken courses on comprehensive dentistry from nearly everyone imaginable and for the first time I get it, it makes sense, and it’s easy! Don explains the most misunderstood topic in dentistry in a way that is easy to follow, easy to remember, and easy to implement.”

Zachary Potts, DDS; Port Hueneme, CA “Dr. Reid lives by the prudent philosophy ‘The best dentistry is no dentistry and a good bite!’ He’s a fellow pioneer in preventive and behavioral practice. As a founding father of the newly formed Congress Of Microscope Enhanced Dentistry ( 2002), his enhanced vision gives him expanded information to share with our profession. His warmth and authenticity will disarm you and his enthusiasm is contagious.”

Omer K Reed DDS; Phoenix, AZ “Dr. Reid’s vast knowledge of bite management makes him an extremely effective speaker who really motivated me to be the best doctor I can possibly be. I learned so much from his course it has changed what I feel is possible in my practice.”.

Dr. Jason Melashenko; Surprise, AZ “Not only was Dr. Reid’s knowledge of occlusion impressive, but his delivery and non-condescending explanation of occlusion was amazing. Dr. Reid helped me understand occlusion, as well as teaching me ways I could better treat my patients with occlusal trauma.”

Kevin K. Shim, DDS; Gresham, OR



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49A Case Study in Handling and Explaining Occlusal Disease

Occlusal disease is one of the most destructive and neglected elements in dentistryand plays a major role in reducing the longevity of our finest restorative efforts. Itcan present itself in the form of painful, clicking TM joints, sore facial muscles,headaches, tooth wear, tooth looseness, sensitivity, and migration. It is a dominantfactor in the fracture of restorations on posterior teeth.

Although a dentist may understand the cause and effect of these destructive forces,explaining these concepts to patients and their families can be very difficult. It ismuch easier to discuss the solution for caries or fractured teeth than it is to describehow excess wear is caused by a movement of the mandible from maximum intercus-pation, in and out of a centric relation position. Likewise, understanding how ➪

A case study in handling and explaining occlusal diseaseSeeing is believing...

– ARTICLE by Don Reid, DDS

– PHOTOS & ILLUSTRATIONSprovided by D2Effects LLC

50 A Case Study in Handling and Explaining Occlusal Disease50

interferences on the balancing or non-working side during lateral excursions occuris difficult enough for dentists to see and detect, this difficulty is only compoundedwhen we try to explain these problems to patients. Difficult or not, we are obligat-ed to offer a treatment plan for the resolution of all disease categories which fallwithin our scope of health care service.

CASE REPORTA middle aged lady reported to my office with a request to have an implant crownplaced on an integrated implant in the lower left #18 area (Fig. 1). Upon cursoryexamination, I observed signs of severe wear, occlusal disease, throughout themouth and quite notably in the lower left quadrant (Fig. 2). I informed her of my con-cern, that implant success or failure after osteointegration was largely dependent onhaving proper distribution of the biting forces. I assured her we’d restore the implantfor the greatest potential for long term success and asked for the opportunity tostudy her case further prior to making restorative decisions. She rescheduled for acomplete examination which included (1.) full mouth x-rays, (2.) nine intraoral pho-tographs (Canon Digital Rebel), (3.) Panorex, and (4.) mounted study models (SAMIII) in centric relation.

A complete examination was conducted evaluating the TMJ, muscles, periodontalstructures, occlusion, and an oral cancer screening was performed. The tooth bytooth exam, looking for excess wear, looseness, fractures and caries, was aided bythe use of a dental operating microscope (Global Protégé).

Due to facial muscle tightness, I fabricated an anterior deprogramming device andasked her to wear it at night and monitor the effects on her muscles and jaw. Shewas then scheduled for a treatment plan consultation.

Fig. 2 Lower left arch for implant crown. Fig. 1 Existing implant in lower left #18 area. Fig. 3 Upper occlusal view before treatment.

Case Report

51A Case Study in Handling and Explaining Occlusal Disease 51

THE HISTORYThe patient’s history included tooth loss of #18 due to a fracture of the crown as well as a recent history of loosening, fracturing and early replacement of all-ceram-ic restoration on #8 and 9 (Figs. 2 & 3). She stated she has a habit of grinding herteeth and felt that was contributing towards the crown failure. Additionally, thepatient was not pleased with the appearance of her smile as she felt her teeth weretoo short. Her long term goal was to keep her natural teeth for life and avoid repeat-ed dental treatment.

CLINICAL FINDINGSThe periodontal structures were quite healthy and there was minimal evidence ofcaries. There was muscle tenderness upon direct palpation of the masseters, tempo-ralis, and medial pterygoids as well as the lateral pterygoids upon indirect palpation.

There was excessive hypertrophy of the masseters as well as the temporalis muscles.The mandible had full range of motion in all possible movements. There were nointracapsular disorders of the TMJ as determined by Doppler auscultation and loadtesting. There was severe wear throughout the mouth as well as abfractions alongwith slight tooth mobility. There was a CR contact on the distal of #19, with a 2mmvertical component and a 2mm forward component into maximal intercuspation(MI). There were interferences in lateral excursions on the working and non work-ing sides bilaterally. Protrusive was WNL.

The potential for repeated crown fracturing, as well as potential implant failure dueto destructive forces of occlusion, was very high. Allowing these destructive forcesto persist could cause implant failure, restorative failure, or tooth loss. Not treatingthis disease would have severe implications for the patient. ➪

Figs. 4, 5, 6 Tooth wear and abfractions.

Clinical Findings

TOOTHWEAR

ABFRACTIONS

TOOTH WEAR

ABFRACTIONS

52 A Case Study in Handling and Explaining Occlusal Disease

Demonstrating Joint Position

Figs. 7, 8 Animationshowing muscle func-

tion and removing ten-sion in pterygoids.

Figs. 9 & 10Animations contrastingstable (left) and unsta-ble (right) bites.

CONSULTATION TIMEUsing her mounted models, I was able to show my client how worn her natural teeth had become. The models were mounted in CR so the first contact was on tooth #19 and there were lateral interferences in all eccentric jaw movements.

In the past, these findings were important yet difficult for the patient to understandeven with mounted models. My goal in creating BiteFX™ was to show patients therelevance of proper joint position, normal muscle function, the role of proper ante-rior guidance, and finally the value of ideal tooth contacts in a way that could beeasily understood.

The patient had experienced remarkable relief of facial muscle soreness with thedeprogrammer so I began by educating her on the reason behind this success.Through animations (illustrated in Figs. 7 & 8), the client could see how the musclesclosed the jaw and allowed the joint to fully seat, removing the tension in the ptery-goid muscles. This had the net effect of changing the mandible position and causingthe teeth to fit differently after nighttime usage.

PROPER JOINT POSITIONI was able to show the patient the difference between a stable bite, with CR in har-mony with MI and no ability to slide forward and backwards on the back teeth, andan unstable bite by showing two contrasting BiteFX animations (Figs. 9 &10).

NORMAL MUSCLE FUNCTIONTo explain her muscle tenderness I showed her two animations; one illustrating nor-mal muscle function (Fig. 11) and the other showing hyper-muscle activity (Fig. 12).

53A Case Study in Handling and Explaining Occlusal Disease 53

Muscle Function /Anterior Guidance

Figs. 11, 12 Normalmuscle function (left)

compared with musclehyper-activity (right).

Figs. 13, 14Animations illustratinganterior guidance.

It was easy to illustrate, that when the jaw closes into a stable bite,it requires nousage of the muscles that position the jaw forward and sideways.

PROPER ANTERIOR GUIDANCEThe patient exhibited severe wear and lateral interferences on both the working andbalancing sides. Using BiteFX animations she could visualize the destructive effectsof her existing occlusal disease, and the benefits of proper anterior guidance assnapped in figures 13-16.

PROPER TOOTH CONTACTSThe animations illustrated in figures 17 and 18 showed the patient proper tooth con-tacts which minimize the contact, wear and stress to the teeth as compared todestructive contacts which can wear, move or break teeth.

ATTAINING CENTRIC RELATION POSITIONI’m often asked how I determine the proper position of the joint. In this case, I repli-cated the action of the closing muscles of the jaw by using bimanual manipulation.In addition, I had her clench repeatedly on an anterior de-programmer. I was ableto attain CR records using both techniques.

TREATMENT PLANNING FOR SUCCESSOnce the patient began to understand the advantages of a stable occlusion, she start-ed to focus on the esthetics of her smile. The occlusal attrition was dramatic and thecentral incisors were as long as they were wide. To establish longer upper frontteeth required opening the vertical dimension as determined by mandibular ➪


Proper Tooth Contacts

Figs. 15, 16 Animation illustrating

the effects of lost ante-rior guidance.

Figs. 17, 18Animations showingideal tooth contacts(left) and comparingproper and destructivetooth contacts (right).

translation and the closest speaking space. Evaluation of this parameter combinedwith the patient’s desires, I requested maxillary centrals 12mm long and correspon-ding lowers 10mm in the diagnostic wax up.

TREATMENT PLAN

Step 1. Continued anterior deprogrammer therapy followed by occlusal equili-bration to include anterior guidance using composite build-ups on the cuspids.

Step 2. New impressions for mounted study models in CR and a full mouth diag-nostic wax up to the desired tooth lengths.

Step 3. Preparation, impression taking, and provisionalization of both archessimultaneously.

Step 4. Evaluation of the form, function, and comfort during the provisionalizationperiod (6 months).

Step 5. Final shade selection, fabrication of all ceramic restorations from firstbicuspid to first bicuspid, and porcelain fused to gold on the remainingposterior teeth.

Step 6. The final phase is impressions and fabrication of the lower implant crown#18. Ironically, this last procedure was the first item requested at the ini-tial office visit. ➪


TREATMENT PHASE

Visit #1 - Equilibration and Diagnostic Wax-up

Wearing the anterior deprogrammer had relaxed the muscles, which allowed for aneasy and complete occlusal equilibration. Full arch impressions using VPS weremade. A SAM III axiomatic bite fork and face bow were taken, as well as CR biterecords using Futar D.

Since centric relation is independent of tooth contact or position, I take the recordat a 2-4 mm vertical opening to maintain adequate thickness of the recording mate-rial. This enables the laboratory to avoid breakage due to thinness of material. Theclient selected a smile she liked and that guided the Rx for the diagnostic wax up.

Digital photos of the client’s existing smile were included with the prescription. Thevertical dimension of occlusion (VDO) was determined by the height necessary toaccommodate adequate speaking space.

Visit #2 - Preparation

Preplanning and visualization of both the occlusal scheme and final tooth shape andposition are essential for predictable and efficient treatment.

Beginning with ‘The end in mind’ includes having clear provisional matrices, ‘suckdown’ prep guides, replica stone models of the diagnostic wax up, as well as mount-ed waxed models available at the start of treatment.

An electric hand piece and new Brasseler diamonds allowed for an effective 5 hourvisit during which both arches were prepped, final impressions were taken, and pro-visionals placed. CR bite records as well as facebow were taken.

Temporaries

Figs. 19, 22 The patient’s temporaries.

57A Case Study in Handling and Explaining Occlusal Disease

Visit #3 - The Test Drive

This is the period where the newly increased VDO is evaluated with emphasis onspeech and esthetics. The temporaries (Figs. 19 - 22) were modified to the patient’sdesires (i.e. more pointed canines), and alginate impressions, digital photos and face-bow records were given to the lab to create the final restorations.

Visit #4 - Shade Selection

The client opted for very white teeth. The Vitapan 3D shade guide was used. A sin-gle incisor was fabricated and tried in to get the patient’s approval prior to complet-ing the entire case.

Visit #5 - Expect the Unexpected

During the 6 month trial test drive, the pulp of #3 was irreversibly inflamed. Thetooth had a prior history of severe pain after a crown was placed several decadesago. The client rejected the option of saving the tooth with root canal therapy andchose extraction and bone grafting, followed by implant placement and implantretained crown (Figs. 23 - 24). The extraction and bone graft were completed usingGrafton matrix and Pepgin N -15.

After 4 months, a 6mm x 9mm Biohorizons D4 Maestro implant was placed andsimultaneously a “Sinus Lift” of 3mm was performed with flat ended osteotomes anda conservative tissue punch access rather than a full flap.

Visit #6 - Completion

The final restorations (Figs. 25 - 30) were placed using RelyX bonding agent for therefractory porcelain and Fuji GC luting cement for the posterior PFMs. The deliveryappointment went smoothly and required only ‘spot adjusting’ in several areas. ➪

Implants / Final Restorations

Figs. 23, 24 Placingthe implant for #3.

Figs. 25, 26Final restorations.


There was no hint of a CR slide and all eccentric jaw motions were WNL!

CONCLUSIONPlacing an implant or any final restoration in an environment where it has the poten-tial to fail due to destructive occlusal forces is unwise. Communicating the effect ofocclusal disease can be frustrating and difficult yet nonetheless it is our responsi-bility as health professionals.

Realizing that all patients may not require nor want extensive full mouth reconstruc-tion, a simpler solution would have been to equilibrate and restore anterior guidancewith a minimal approach using composites. Her muscle soreness would be eliminat-ed and the potential for repeated porcelain failure would be very minimal.

The beauty of understanding and presenting solutions to occlusion disease is thatwhether you are doing something very minimal or, as in this case, major, the casecan be completed in phases (one arch or anterior segment at a time). The treatmentprinciples are the same regardless of scope of treatment. This case started with adesire to do a single implant crown on #18. The patient was also concerned aboutrepeated crown loosening and fracture and she was aware of grinding her teeth.

With the help of 3D animations, I was able to demonstrate the destructive effectscaused by an unstable occlusion which increased her understanding and confidenceto accept a rather extensive treatment plan. The result is a beautiful healthy smilethat will last.

Final Restorations

Figs. 27-30 Final restorations.

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