Jane was concerned about the overall appearance of her teeth. Over the years, her teeth had developed excessive wear patterns, causing them to look square shaped and worn out. Additionally, her gums were showing troubling signs of recession associated with greater dental health issues. Jane previously used teeth whitening products, but an increasing sensitivity had forced her to stop. She felt that all of this was adding years to her appearance, and approached Dr. Ueckert in an effort to resolve these problems.
During the initial consultation, Dr. Ueckert discovered symptoms consistent with TMJ Disorder. Jane had a long history of clenching and grinding her teeth at night. A previous dentist had created a night guard for her, which was extremely effective at mitigating her symptoms. Her biggest problem was when she forgot to wear the night guard. The next morning she would wake up with a lot of pain and discomfort. This included bilateral soreness in the temporomandibular joint, pain and stiffness in the neck, tinnitus and tightness of the massater muscles.
Another issue that concerned Dr Ueckert was the head tilt that Jane exhibited. By examining Jane’s before and after portraits, there is a noticeable tilt to her left side. This canted head position is a common sign that the lower jaw to upper jaw relationship has moved away from its optimal bite position.
COURSE OF TREATMENT
A neuromuscular approach to helping Jane was suggested by Dr. Ueckert. This process began with tests to gather objective baseline data, which would provide the measurements of exactly where Jane’s bite should be. A comprehensive evaluation identified abnormal jaw movements, tested for muscle imbalances and examined joint function.
Neuromuscular – Dr. Ueckert Reviewing Case
Neuromuscular – Occlusional Bite Position
After the ideal bite position was determined, Dr. Ueckert created an orthotic specific for Jane. The orthotic would allow to test drive her new bite position before any permanent changes were made to her existing teeth. Throughout the treatment, they spent time refining and adjusting the orthotic, to maximize the occlusal bite position.
Neuromuscular – Wax Model Articulation
Neuromuscular – Orthotic for Perfect Occlusion
With full time use of the corrective orthotic, Jane’s symptoms became diminished. They still occurred, but with less intensity and frequency. This was her first sign that treatment was working. She no longer needed to sleep with the night guard and was waking up in the morning feeling rested, without any pain or soreness. As her new bite position stabilized, it was time for discussion on how to finalize her optimized bite position.
Since she had initially been unhappy with the appearance of her teeth, porcelain restorations were chosen. Dr. Ueckert used porcelain crowns give Jane the smile she wanted and support the jaw in its new optimized position. Finalizing Jane’s bite with this restoration process gave her the natural look she wanted, while allowing her body to function in an optimal manner without pain. This is the importance of an ideal neuromuscular bite position.
Neuromuscular Smile: Front
Neuromuscular Smile: Right
Neuromuscular Retractrd Treatment