The modern life has brought facilities, new habits and trends. In dentistry, it resulted in an esthetic appeal where customers seek each day to improve their self-esteem through dental eshetic treatments. Meanwhile the daily stress of modern life also brought a burden and it is becoming more and more common patients coming to us with signs and symptoms of TMD (temporomandibular dysfunction), due to clenching or grinding, resulting in myalgia, joint problems, dental wear, abfraction, dental fractures, bone loss, among others.
It is the duty of the clinician, even not being a specialist in the area, to know how to identify these signs and alert the patient to seek the appropriate treatment to preserve the dental component and related structures. The mutually protected occlusion should be observed and evaluated as a routine in all dentate patients in the same way that we do anamnesis, radiographic and clinical examination. In the mutually protected occlusion we must observe that in MI (maximum intercuspation) posterior teeth occlude releasing the anterior teeth of contact and, in the jaw movements (protrusive and laterally) anterior teeth touch while posterior do not.
On the other hand, the clinician can never perform restorative procedures, direct or indirect, and leave the restoration(s) in infraocclusion or with a contour that changes the occlusal pattern of the patient and that may result in a TMD. Sometimes we are faced with situations where simplicity is the best way. Reduce the working time at the office with efficiency is necessary. When we are confronted with preparations for indirect restorations, the evaluation of interoclusal space for such restoration is difficult and, often, we have to do it with a provisional. This process is time consuming because it requires redoing the provisional many times. Insufficient wear during the preparation leads to errors that result in excess in the contour, usually when testing the copping. A viable alternative for this situation is the evaluation of space for application of porcelain in coopings, metalic or not, using an light curing acrylic resin as we see illustrated below. In this case we used a provisional restorative material - Bioplic (Biodynamics). The clinical case illustrated was performed by Thais Felipe Pellegrin, our student at the Cosmetic Dentistry Specialization Cours at AORP.
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My purpose is to help you gain autonomy through knowledge, facilitating the dentistry and communication. AND how do I do this?
I put myself in your shoed, I identify what is preventing you from being happy with your results and untie the knots by means of a simple and accessible language! I graduated from UNESP | Araçatuba; did my Master and PhD in Operative Dentistry at UNESP Araraquara | I am a Professor of Operative Dentistry at the Federal University of Pelotas | RS.
Jul, 27th 2015