Alright Friends, I had a patient referred to me by a periodontist who needed a new general dentist.

Patient is a 70 year old female with history of trauma to her maxillary anterior teeth in her late 20's.

She is seen every 3-4 months for hygiene at the periodontist and her primary reason for her visit was a dental exam.

I completed an EFSB exam and have her scheduled for a consultation appointment.

Esthetics:

Incisal edge position of 8 looks good, but 7,9,10 are too long

Tooth wear- severe wear on 22-27 with secondary eruption

High lip mobility

Irregular gingival levels

Poor/No papilla 6-11

Long contacts

Function:

No jaw joint or muscle pain

100% overbite

Severe wear on 22-27

Class II mobility: #7, FPD 10-12

Class I mobility #9

Structure:

Decay:#3, #12,#18,#20, #30

Impacted #1,#11,#16,#17,#32

Fractured teeth/Restorations: #3, #18

Biology:

Chronic generalized moderate to severe periodontal disease

Moderate to severe maxillary bone loss

Endodontic concerns: #30, #14 (periodontal)

Very complicated case, any idea's on treatment planning this case and in particular what to do with the failing FPD #10-#12?

Thanks for your help.

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