
Occlusion 2 – complex and interdisciplinary cases
- Why is centric relation relevant? When should it be used?
- Which is the best technique to identify it and record it?
- Is it better to manipulate the patient or to let him/her close autonomously?
- If a patient with extensive wear needs to be rehabilitated, how do we decide by how much
to open the vertical dimension? - Why bother proposing an orthodontic movement to a patient when, often, you can solve the challenge prosthetically?
- What can realistically be done by an orthodontist to facilitate the work of a prosthodontist?
- What do you have to know when you want to create an effective collaboration and teamwork between an orthodontist and a restorative dentist?

Topics
OCCLUSION IN EXTENSIVE REHABILITATIONS
Whenever we need to make prostheses for our patients, the question arises of the inter-jaw position at which to fabricate them: maximum intercuspation or centric relationship? This is (or should be!) the dilemma and this dilemma is all the more relevant the more the involvement of the patient’s teeth is extended, from a few elements to the rehabilitation of both arches. In fact, the progressive lack of reliable references at occlusal level raises the need to look elsewhere for the coordinates to put the maxillary arch into the right relationship with the mandibular arch.
The criteria for choosing the most suitable condylar and dental position when deciding which scheme and occlusal contacts to develop in the different types of prosthetic solutions are illustrated in detail. As a matter of fact, this course aims to explain in simple and practical terms the approach to occlusal integration of prosthetic restorations, from the single crown to the complete rehabilitation of the two arches, regardless of whether they are supported by teeth or implants. It will explain not only how, but also (and above all) the reason for a clinical approach supported by 30 years of clinical experience.
THE TREATMENT OF PATIENTS WITH EXTENSIVE WEAR
When confronted with the treatment of patients with extensive loss of tooth structure due to abrasions and/or erosions, there are several dilemmas to be clarified: what is causing this loss? Is it abrasion, friction or erosion? Is the patient a bruxer? Has vertical dimension been lost? What therapies should be provided? What restorative materials should be used? In this part of the program, the instructor will illustrate the correct clinical approach to replace the tooth structure without further compromising the teeth and, at the same time, creating the conditions to protect both the teeth and the rehabilitation for the years to come.
THE INTERDISCIPLINARY TREATMENT OF PATIENTS WITH IMPLANT AND ORTHODONTIC NEEDS
In many partially edentulous patients requiring prosthesis and osseointegrated implants, orthodontic treatment is indicated to reposition natural teeth.
This may be important to correct the sagittal, vertical and transverse positions of the teeth to improve masticatory function, create the necessary space for restoring the mesio-distal dimension of the crowns and obtain a satisfactory and natural looking esthetic outcome.
Osseointegrated implants, as well as non-integrated mini-implants or temporary anchorage devices (TADs), can be used as anchorage to carry out the planned orthodontic movements, especially in patients with many missing teeth, and to support temporary crowns in edentulous areas. The treatment of such patients implicates a complete diagnosis, careful planning and an efficient line of communication between the orthodontist and the prosthodontist.
This lecture will illustrate the variables that should be taken into consideration when a combined ortho-implant-prosthetic treatment is necessary. Among them, the minimum age that the patient should have in order to be a candidate for implant therapy is going to be analysed on the basis of the current evidence published in the literature. Several clinical cases will help demonstrate the decision-making process.
Course Objectives
AT THE END OF THE COURSE, THE PARTECIPANTS WILL HAVE LEARNED
OCCLUSION IN EXTENSIVE REHABILITATIONS
- The techniques for recording centric relation
- The strategies for setting articulators with individual values
- The occlusal scheme when extensive rehabilitations are carried out
- How to develop an esthetic anterior guidance
- If, when and how to vary occlusal vertical dimension
- How to transfer occlusal information from the temporary to the final: the cross-mounting with the models of the provisionals
- When it is useful to make an esthetic mock-up or an ortho-prosthetic set-up and how to do them
THE TREATMENT OF PATIENTS WITH EXTENSIVE WEAR
- How to recognize the etiology of wear facets
- The most common causes of dental erosion
- How to instruct patients to avoid harmful behavior for teeth
- The sequence of therapeutic phases for the prosthetic rehabilitation of these patients
- The role of the mock-up
THE INTERDISCIPLINARY TREATMENT OF PATIENTS WITH IMPLANT AND ORTHODONTIC NEEDS
- When orthodontic therapy should be considered
- The criteria for deciding whether a space should be opened or closed orthodontically
- The types of anchorage that can be employed to carry out different kinds of movements
- The minimum age at which a patient can be a candidate for implant therapy
- On what basis to communicate with your orthodontist in order to define the desired preprosthetic orthodontic movements
Pratical Excersises and Demonstrations
ANALOG WORKFLOW
The intermaxillary registration in centric relation: the application of different techniques
DIGITAL WORKFLOW
The use of digital recorders of the mandibular movement and the use of this data for setting the virtual articulator
Program of this module
THURSDAY (9:00 – 18:30)
- 09:00 – 09:30
Introduction and presentation of the participants - 09:30 – 11:00
The approach to the rehabilitations in centric relation and the strategies for the development
of an esthetic anterior guidance - 11:00 – 11:30
COFFEE BREAK - 11:30 – 13:00
The treatment of patients with extensive dental wear: diagnosis and therapeutic strategies
Exercise con acetati - 13:00 – 14:00
LUNCH - 14:00 – 16:00
Practical exercises and demonstrations – How to register CR with different techniques
Practical exercises and demonstrations – How to record individual excursive movements - 16:00 – 16:30
BREAK - 16:30 – 18:30
Clinical examples of rehabilitations built in centric relation: comparing analog and digital workflows (Part 1) - 19:00
Welcome reception on the Terrace
FRIDAY (9:00-18:30)
- 09:00 – 11:00
Clinical examples of rehabilitations built in centric relation: comparing analog and digital workflows (Part 2) - 11:00 – 11:30
COFFEE BREAK - 11:30 – 13:00
Clinical examples of rehabilitations built in centric relation: comparing analog and digital workflows (Part 3) - 13:00 – 14:00
LUNCH - 14:00 – 16:00
Clinical examples of rehabilitations built in centric relation: comparing analog and digital workflows (Part 4) - 16:00 – 16:30
BREAK - 16:30 – 18:30
Discussion of clinical cases treated by participants - 20:00
GROUP DINNER
SATURDAY (9:00-17:00)
- 09:00 – 11:00
The interdisciplinary approach to ortho-prosthetic clinical cases when implants are contemplated (Part 1) - 11:00 – 11:30
COFFEE BREAK - 11:30 – 13:00
The interdisciplinary approach to ortho-prosthetic clinical cases when implants are contemplated (Part 2) - 13:00 – 14:00
LUNCH - 14:00 – 17:00
The interdisciplinary approach to ortho-prosthetic clinical cases when implants are contemplated (Part 3) - 17:00
Concluding remarks
Costs
THIS MODULE | PACKAGES | |
---|---|---|
Dentist | € 2,950.00 + VAT | € 14,750.00 + VAT for all 6 modules (instead of € 17,700.00 + VAT, that is you get one module for free) |
Young professional under 30 years old | € 1,950.00 + VAT | |
Dental Technician | € 1,250.00 + VAT | € 4,600.00 + VAT for modules 3-6 |
Orthodontist | € 1,250.00 + VAT |
The fee covers all lunches and coffee breaks for the three days and a group dinner on Friday evening. Hotel accommodation and the other dinners are not covered.
Book Now
Book, without obligation, the module (or modules) of your interest. Our secretariat will contact you as soon as possible to give you all the necessary information.
MAKE YOUR CLINICIAN-DENTAL TECHNICIAN TEAM GROW
Participants can invite their orthodontists to participate at a reduced rate to the interdisciplinary treatment day in which Dr. Gracis and Dr. De Franco will illustrate in detail the ortho-prosthetic cases treated together. (Link to the table with costs)
