09.00-11.00: 14 WORDS, rehabilitation versus reconstruction
14 years are already passed since the first time the 3STEP was proposed. Nowadays the indications are exponentially increased. The force of a 3STEP is the capacity to do a test drive on patients before restoring them, all done in composite and in ADDITIVE manner. Thanks to these two characteristic the 3STEP is not a technique, but it becomes an essential protocol for any clinician who what to treat a patients, stabilising the occlusion and improving the function. In this presentation 14 key words will be illustrated to show how the 3STEP could become essential part in a dental practice.
- Understand that the 3STEP is more than a simple technique. It is protocol and a guide to know better each patient before starting with final restorations
11.00-13.00: Advance diagnosis
Often the diagnosis is lacking in case of restoring worn down incisal edges. In the author’s opinion, clinicians should identify the mechanics of the wear before starting the reconstruction. If the original (the enamel) broke down can a REPAIR perform better? In case of Erosion, yes, but in case of functional problems NO. In this presentation, a case of severe wear treated with a 3STEP with 10 year follow-up will be used to warn clinicians about the problems related to a lack of initial correct diagnosis.
- Identify the different errors during the reconstruction of a dentition of a patient who was not correctly diagnosed and rehabilitated
14.00-15.30: Centered mandibles, how and why?
The 3STEP has a strict protocol about the initial position of the mandible before starting the rehabilitation. The mandible should be in a muscular therapeutic position of comfort. The different ways to record this position will be explained, with a review of the 5 points essential in planning a rehabilitation.
review the 5 points:
- How to articulate the models?
- How much give to the maxillary arch?
- How much to increase the VDO?
- How to distribute the posterior space?
- Which type of white bite?
16.00-18.00: Revisited Planas, deep bite, ageing, and unilateral function
In this part of the course, Dr. Vailati will share her way of analysis patients, defined the desert island’s protocol.In a complex panorama about function, analysing a patient may become very complex and expensive. Can a functional diagnosis be done also in a simplified, but still efficient manner, to be really used everyday? This is the aim of Dr. Vailati’s work. In this project, Dr. Pedro Planas’ ideas are perfect, adding value to particular topic such as physiologic ageing and tooth wear.
In modern time, esthetic has gained more space in the treatment plan than function. However, planning a full-mouth rehabilitation only based on esthetic requests could be very risky. The risk of worsening deep bite (and compromising patient’s function), while rejuvenating the patient’s smile is very common. Three different phases in treatment planning can be identified, based on the different parameters considered important by each clinician during the therapy. Dentists are in phase 1 of their professional life when they consider that the most important function of the mouth is smiling. This attitude is very dangerous, since it increases the risks of restoration failure.
A simplified approach to achieve a rehabilitation, which doesn’t only look esthetic, but also functions well is derived from the clinical observations of Dr. Pedro Planas. His ideas have been fully integrated in the work of Dr. Vailati to improve the comfort of the patient and the longevity of the restorations.
Thanks to his work, dentists can learn how to analyse the movements of the mouth and determine if they are physiologic or pathological.
The development of the condyles, mandible and maxilla will be considered and information on how a dentition should age will be given.
- Learn about the movements of the jaw
- Learn Planas’ laws on the development of the mouth
- Learn the potential risks of a deep bite
- Define how a dentition should age
- Decide to design the smile using an intelligent esthetic