Hello,

I am stuck on how to proceed with treatment plan for Derek. He is 58 and medically no issues. He has been a patient of mine for a while. Each time I see him, I ask him if he is interested in knowing what we can do for him: esthetically, as well as functionally, addressing the missing teeth, and short crowns, that every once in a while I have to recement. So he finally agreed, and wants to know "what can be done, because I am tired of my crowns coming out"

He is strongly opposed to Ortho, as he says "definetely, not at my age! No way!"

I would appreciate any feedback on this. My thoughts are:

Perio Consult: I like the gingival height of #11. Consult to see if with crown lengthening we can get more clinical crown, more symmetry, more retention, and be able to make longer crowns.

New crowns on upper anteriors to be thinner on the lingual. Thus, we might be able to also do crown lengthening on the lower anteriors, and also make new crowns that would be slightly protruded, to address overbite

extract 1, 16

replace bridge 12-14, and create more interocclusal space for future implant on #19 site. Same for #2: crown to make the crown more functional, and create more space for future implant #30

crowns on 20,21, 28, and bridge 4-6

Partial/stayplate, while the patient is healing from implant

Implant crowns #3, 19, 30

Bridge 29-30(implant)-32

I am not sure if it would be better to just have a first-molar-bite on the right side, so extract 3 and 32 also, and have the bite be on implant crowns 3/30

Thank you in advance,

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