Transcript Lorraine_S_-_PGocclusion

Ronald G. Presswood
Adjunct Professor
School of Clinical Dentistry
Lorraine S.
Five years of pain and obsession.
Three restorative events,
numerous splints.
Asked us to make a splint after
almost a year of observation.
Previous Splints, Five Years
Current Max
Anterior RP.
Teeth do not
fit together .
Failed Restorations, UR
Crowns required
Extensive
Adjustment.
Often Came
Uncemented
Initial Seat, PGA, Pain R
Which contacts
stimulate
pain on the right?
1st Adj, much better, 11/8/05
Why?
This guide supports R TMJ.
Resurface Posterior, 11/15/05
One week after initial
placement.
Why do you think
this was done?
Add the
balancing
guide!
Resurface Posterior, 11/15/05
What did we gain?
1st Adjustment, 11/15/05
3rd Adjustment, 11/15/05
Anything
wrong
on the splint?
4th, Final Adjustment, 11/15/05
Initial Check, Sore R, 11/21/05
Why is
she sore
on the right?
Could it be an
Anterior Guide
Issue?
1st Adjustment, OK, 11/21/05
Done
Yet?
NO!!!
What’s the
issue?
2nd, Final Adjustment, 11/21/05
Are you looking at the ink, or the streak.
Initial mark, #4 “soft”, 11/28/05
Upper Bi is
tender to
percussion
and
1+ mobile.
How did we
get this
marking??
Why did we
want it?
2nd mark, #4 better, 11/28/05
Anything else
get your
Attention?
3rd mark, all ok (OK?), 11/28/05
Is this splint
OK for patient
to leave?
What about 10, UL 2
and 12, UL 4?
Initial mark, Pain R, 11/30/05
Pain on right
keeps coming
back.
What do you think
is changing?
Could a muscle
be releasing?
Why are the
markings
so small?
Or, could a joint
be healing?
Inflammation
going
away?
Almost complete, one last thing
Slight discomfort on right.
What do you
think is causing
the problem?
What you think
about having
only 2nd molar
contacts?
Initial Mark, Feels Good, 12/5/05
Light Tap
=
MIP
3rd Adj., R click, 12/5/05
Why is there
a right click?
What marks
are involved?
What instrument is used
to remove
the contact?
3rd Adj., No click, 12/5/05
So,
which
contacts
did we
remove?
Which Tooth Contacts Are Bad?
Which
contacts,
in which
order?
Which Tooth Contacts Are Bad?
Which
contacts,
in which
order?
Relieved
on maxillary
teeth
Balancing
Guides
Muscle Pain R #2, 12/15/05
What’s
the
Issue?
5th, final, adjustment, 12/15/05
Any bad
Contacts?
What are
these?
Initial Mark, Feels Good, 3/1/06
From Dec. 15
until March 1,
she was seen
weekly.
MUSCLE AND
JOINT HAVE
NOT BEEN A
MAJOR ISSUE
SINCE
JANUARY.
Any
unhealthy
contacts?
Initial Mark, Feels Good, 3/1/06
Same Marks,
Different
Perspective.
Where are the
bad ones?
Use of personal photographs
Dear Dr. Presswood,
Yes, you have my permission to display the two photos taken of me while
under your care.
I wish you continued good work with your clinical studies, which I hope
will be able to help more people- just like you have helped me.
Because of you and your care, I now have a better quality of life.
Sincerely,
Lorraine S
6 November 2009
Pre and Post Photos, 6 Months
12/2006
05/2007
Attending Doctors
Neurologist
 Internist
 Physical Therapist
 DDS, PhD, Pain Specialist


Ron Presswood, General Dentist
Who is doing the better job from
the patients perspective?
Why do you think that?
Dear Dr. Presswood,
I hope that your summer is progressing well and that you and yours are
doing fine!
I am writing to tell you that in six years time, I am having the best
summer since 2001!!!!!
I have reduced my Gabapentin by 100 mg. to a total of 800 mg. daily. I
have had some "bad days", but nothing compared to the past. I wear my
splint 24/7 and only take it out to eat. I can tell that my "bite" is
not firm or sound, but while wearing the splint........... it is solid.
My muscles seem to have calmed down quite a bit with all of the splint
adjustments that you made Nov. -May.
This is the first time in six years that I am anxious to return to
Houston. I will call Lisa to make an appt. so you can slowly start to
adjust my bite on my real teeth! I am optimistic that you can help me
even more.
I don't know how to begin to thank you. You have made such a difference
in my life -all for the better.
George, Abby and I are having a record September for visiting house
guests -friends and family. We love having company visit, since we're
gone from Houston so much. Also, our friends like to get "out of the
heat"!
I never did actually invite you, but you and your wife are always welcome
to come to the mountains and visit us here -(Sept. is "booked"!!!) Maybe
October?
Please give Lisa and Julie my best. I will see you all in November for
sure.
Sincerely and with heartfelt thanks,
Lorraine S., August 31, 2006
Thanks for your attention!!