Candi D. is a new patient referred to me in June with a history of having had treatment by at least four dentists. The attached pdf illustrates the following:

Candi’s Chief Complaint:

1.Can not find a comfortable place to chew

2. pain in all of the upper and lower back teeth

History

Provisional restoration #2 - #8
Restorative treatment #12 & #13
Extraction of Endodontically treated teeth # 3 # 5 #7
Full Coverage Restorations #12 #13
Ceramic Implants sites #3 & #5
nine months in appliance therapy -

Treatment since June 19 2015

Replace Provisional restoration #2 - #8
Place a full coverage Zirconia # 2
Occlusal muscle exam - all muscles tender
TMJ - WNL
Chief Complaint as stated above

Finding

Anterior open bite - contact #6 thru #11 in MIP position
Centric Relation & MIP nearly coincident - slight slide

Diagnosis

No anterior guidance coupled with no stable place to close to
Episodes of muscle tenderness
Vertical dimension is too much for this patients adaptive capacity
At the vertical dimension of rest the Patient reports tooth contact therefore no freeway space and over open vertical dimension