A System for Stability

Dr. Mike Miyasaki

Dr. Mike Miyasaki

During this year we have seen many fantastic aesthetic cases performed by the PAC course doctors and faculty created by the Corr Dental Designs. Improved aesthetics can be a wonderful service we can provide to our patients, and besides how comfortable we keep them, the appearance of our work is probably one of the most important ways our patients judge our work and skills. But we know we have to develop aesthetics that function for the best cosmetic result and longevity. The PAC has spent hours this year to provide education on occlusion and function. What makes the PAC education unique is that we understand how to work with the most popular occlusal philosophies and allow the doctors to work up their cases in the manner they feel most proficient. What we ask is that they take the time to do a comprehensive examination, and if there are signs of occlusal instability (figures 1 and 2) that they inform the patient.mfigure1-4 If the patient doesn’t value treating the functional challenges then we let the patient know the risks of doing so. If the patient wishes to address the functional issues we ask that the case is stabilized before moving onto the definitive restorative stage and that this is the most conservative option we choose with our informed patient. I feel this is a good approach to responsible dental care and I emphasize ‘care’.

In the month of November, we were able to demonstrate the use of bioelectric diagnostic equipment at the course taught in Detroit led by Dr. Robert DiPilla. Using Myotronic’s equipment we presented what I think was a thought provoking experience for those in attendance to see how jaw position affected the muscle activity generate at rest, in maximum intercuspation, and in function. We were able to see how in space we could pick points where we could obviously see where the muscles were the most comfortable and move the patient’s mandible to that position to take a bite record (figure 3). How many times have we all taken a ‘bite’ by having the patient move to a position that looked ‘right’. Sometimes that bite ‘worked’ and sometimes it didn’t. Sometimes ‘worked’ meant the patient could bite down and hit all the teeth evenly, but to get into that position was the mandible in a truly physiologic position or was the patient having to adapt their jaw position (the moving part of the stomatognathic system) to accommodate closure into MIP? And over time would this develop into a bruxing problem or cause our patient to develop headaches from the muscle hyperactivity of going to this adapted position thousand times a day?

In my June PAC newsletter article, I showed the removable orthotic which is what I often choose to use when I first begin treating a patient. Dr. Robert Jankelson told me he felt he was able to equilibrate the removable orthotic the best because it could be removed from them the mouth and adjusted with the best of visibility. But with a removable orthotic the patient may be in their ideal physiologic position and yet the best healing may not be able to be achieved because when the orthotic is removed the joints and muscles go back into their pathologic position. This does not happen with the fixed orthotic (Figure 4) because it is left in the mouth 24/7. Once you have the proper maxilla-mandible orientation (Figure 5 and 6) the laboratory will do a diagnostic wax-up and create a putty stent that is used in the same manner the PAC teaches during the fabrication of their temporaries. In this fixed appliance adjustments are seen as a sign of healing and when a stable bite is established Phase II options can be considered.mfigure5-6

Following a system like this allows us to work better with the laboratory and establish longer lasting cases with improved aesthetics to truly improve the lives of our patients.

If you have questions about this article or if you would like to send a case, please contact the Pacific Aesthetic Laboratory Group at www.pacificaestheticdentalstudio.com, Gary Vaughn, CDT, CTO (916) 786-6740, or via email gvaughn@thePAC.org.

Figure 1. Teeth that have occlusal attrition or wear
Figure 2. Teeth that have abfraction lesions due to posterior interferences in lateral movement
Figure 3. Plotted jaw position with EMG’s
Figure 4. Fixed orthotic
Figure 5 and 6. Cone beam of condylar position pre-operative and post-operatively

 

By | 2016-11-21T00:46:35+00:00 November 21st, 2016|Uncategorized|0 Comments

About the Author:

No Comments

  1. AndrewDon July 25, 2019 at 10:42 am - Reply
    Your comment is awaiting moderation.

    Many thanks. I enjoy this.

    viagra stimulis viagra in women
    generic viagra
    multiple orgasms with viagra – https://genericviagramsl.com

    Davidmom
    TerenceMog
    Victornag

  2. AndrewDon July 25, 2019 at 10:51 am - Reply
    Your comment is awaiting moderation.

    Kudos, I value it.

    what if viagra does not work viagra caddis fly pattern
    generic viagra 100mg
    but viagra – https://genericviagramsl.com

    Davidmom
    TerenceMog
    Victornag

  3. AndrewDon July 25, 2019 at 11:41 am - Reply
    Your comment is awaiting moderation.

    Awesome facts. Thanks a lot.

    mail order viagra china how to take viagra pills
    generic viagra
    viagra headquarters – https://genericviagrantx.com

    Davidmom
    TerenceMog
    Victornag

  4. AndrewDon July 25, 2019 at 12:29 pm - Reply
    Your comment is awaiting moderation.

    Really quite a lot of amazing knowledge!

    viagra or cealis viagra 50 mg
    viagra online
    viagra tx for pulmonary hypertension – https://genericviagrarcp.com

    Davidmom
    TerenceMog
    Victornag

  5. AndrewDon July 25, 2019 at 1:18 pm - Reply
    Your comment is awaiting moderation.

    Nicely put, With thanks!

    online pharmacy prescription viagra viagra canadian market share
    cheap viagra
    usa generic viagra – https://genericviagrantx.com

    Davidmom
    TerenceMog
    Victornag

  6. AndrewDon July 25, 2019 at 2:54 pm - Reply
    Your comment is awaiting moderation.

    Lovely stuff, Thank you.

    how viagra enhances sex combined viagra cialis ed
    viagra without a doctors prescription
    cialis medicine online order rx viagra – https://genericviagramsl.com

    Davidmom
    TerenceMog
    Victornag

  7. AndrewDon July 25, 2019 at 4:35 pm - Reply
    Your comment is awaiting moderation.

    Cheers! Fantastic information.

    effexor is viagra for women cheapest mail order viagra
    viagra 100mg
    discount bulk viagra india – https://genericviagrantx.com

    Davidmom
    TerenceMog
    Victornag

  8. AndrewDon July 25, 2019 at 5:25 pm - Reply
    Your comment is awaiting moderation.

    Thanks! I appreciate it!

    expired viagra viagra side efeects
    buy generic viagra
    viagra anally in a enema – https://genericviagramsl.com

    Davidmom
    TerenceMog
    Victornag

  9. AndrewDon July 25, 2019 at 6:15 pm - Reply
    Your comment is awaiting moderation.

    Nicely put, Appreciate it!

    cheapest cheap viagra viagra super store
    buy viagra online
    buy diet viagra online – https://genericviagramsl.com

    Davidmom
    TerenceMog
    Victornag

  10. AndrewDon July 25, 2019 at 7:06 pm - Reply
    Your comment is awaiting moderation.

    This is nicely said! !

    is viagra good for you get discount viagra online
    buy generic viagra
    viagra canada free – https://genericviagrantx.com

    Davidmom
    TerenceMog
    Victornag

  11. AndrewDon July 25, 2019 at 7:57 pm - Reply
    Your comment is awaiting moderation.

    Seriously tons of excellent material.

    viagra windsor ca viagra tupperware pool
    generic viagra 100mg
    cheap herbal viagra – https://genericviagrarcp.com

    Davidmom
    TerenceMog
    Victornag

  12. AndrewDon July 25, 2019 at 8:48 pm - Reply
    Your comment is awaiting moderation.

    Regards, Plenty of write ups.

    viagra cailis i took two viagra
    viagra for women
    chinese herbal viagra pills – https://genericviagramsl.com

    Davidmom
    TerenceMog
    Victornag

  13. AndrewDon July 25, 2019 at 9:38 pm - Reply
    Your comment is awaiting moderation.

    Thanks a lot! I enjoy this!

    viagra pr cautions demploi viagra save chrismas
    buy viagra
    viagra prescription low cost – https://genericviagrarcp.com

    Davidmom
    TerenceMog
    Victornag

  14. AndrewDon July 25, 2019 at 10:27 pm - Reply
    Your comment is awaiting moderation.

    Cheers. Fantastic stuff.

    viagra best buy australia viagra
    viagra without a doctors prescription
    cheap viagra 100mg – https://genericviagrarcp.com

    Davidmom
    TerenceMog
    Victornag

  15. AndrewDon July 25, 2019 at 11:18 pm - Reply
    Your comment is awaiting moderation.

    You explained this exceptionally well.

    viagra effect on woman viagra magazine
    viagra without a doctors prescription
    viagra and metoprotol – https://genericviagramsl.com

    Davidmom
    TerenceMog
    Victornag

  16. AndrewDon July 26, 2019 at 12:08 am - Reply
    Your comment is awaiting moderation.

    Valuable knowledge. Cheers!

    viagra works long term side affects of viagra
    generic viagra 100mg
    viagra make it bigger – https://genericviagrarcp.com

    Davidmom
    TerenceMog
    Victornag

  17. AndrewDon July 26, 2019 at 12:58 am - Reply
    Your comment is awaiting moderation.

    Amazing lots of very good material!

    anti viagra natural herbs that act like viagra
    viagra pills
    buy viagra online at – https://genericviagrarcp.com

    Davidmom
    TerenceMog
    Victornag

  18. AndrewDon July 26, 2019 at 1:49 am - Reply
    Your comment is awaiting moderation.

    You actually reported it well!

    viagra altitude subaction showcomments viagra smile blog
    viagra for women
    viagra works best erectile – https://genericviagramsl.com

    Davidmom
    TerenceMog
    Victornag

  19. AndrewDon July 26, 2019 at 2:39 am - Reply
    Your comment is awaiting moderation.

    Regards, A good amount of stuff!

    christine rudakewycz theatrical viagra viagra kamagra uk erectalis
    viagra generic
    super viagra pro – https://genericviagrantx.com

    Davidmom
    TerenceMog
    Victornag

  20. AndrewDon July 26, 2019 at 3:31 am - Reply
    Your comment is awaiting moderation.

    Lovely content. Regards.

    viagra headquarters picture viagra dose
    generic viagra 100mg
    discount brand viagra by pfizer – https://genericviagrarcp.com

    Davidmom
    TerenceMog
    Victornag

  21. AndrewDon July 26, 2019 at 4:21 am - Reply
    Your comment is awaiting moderation.

    Thanks, I appreciate it!

    new alternative drug to viagra generic viagra caverta caverta pillshoprxcom
    viagra without a doctors prescription
    steroids and viagra – https://genericviagrarcp.com

    Davidmom
    TerenceMog
    Victornag

  22. AndrewDon July 26, 2019 at 5:11 am - Reply
    Your comment is awaiting moderation.

    Factor very well used!.

    viagra alerts google charles linskaill reply viagra sex longer harder
    generic viagra 100mg
    official viagra – https://genericviagrarcp.com

    Davidmom
    TerenceMog
    Victornag

  23. AndrewDon July 26, 2019 at 6:00 am - Reply
    Your comment is awaiting moderation.

    Thanks a lot. A lot of forum posts.

    vicodin viagra the use of viagra in women
    viagra 100mg
    viagra tablet size – https://genericviagramsl.com

    Davidmom
    TerenceMog
    Victornag

  24. AndrewDon July 26, 2019 at 6:50 am - Reply
    Your comment is awaiting moderation.

    Wow tons of useful data!

    viagra in peru pharmacy viagra 100mg cheapest
    cheap viagra
    what is viagra made of – https://genericviagrantx.com

    Davidmom
    TerenceMog
    Victornag

  25. AndrewDon July 26, 2019 at 7:41 am - Reply
    Your comment is awaiting moderation.

    You actually explained that effectively.

    natural herbs instead of viagra viagra and teenren
    cheap viagra
    viagra free trial – https://genericviagramsl.com

    Davidmom
    TerenceMog
    Victornag

  26. AndrewDon July 26, 2019 at 8:32 am - Reply
    Your comment is awaiting moderation.

    With thanks, I appreciate it!

    viagra and testosterone pills search viagra viagra edinburgh pages online
    viagra for sale uk
    viagra and vision – https://genericviagramsl.com

    Davidmom
    TerenceMog
    Victornag

  27. AndrewDon July 26, 2019 at 9:23 am - Reply
    Your comment is awaiting moderation.

    Regards. Very good information!

    genuine viagra box making viagra
    buy viagra
    new york walk in viagra prescription – https://genericviagrarcp.com

    Davidmom
    TerenceMog
    Victornag

  28. AndrewDon July 26, 2019 at 10:14 am - Reply
    Your comment is awaiting moderation.

    You’ve made your point pretty clearly!.

    cost of cialis soft vs viagra viagra and statins
    viagra 100mg
    prices of viagra – https://genericviagrarcp.com

    Davidmom
    TerenceMog
    Victornag

  29. AndrewDon July 26, 2019 at 11:07 am - Reply
    Your comment is awaiting moderation.

    You said this adequately.

    taking viagra bodybuilding pump with viagra
    viagra for women
    first viagra pfizer tv ad – https://genericviagrantx.com

    Davidmom
    TerenceMog
    Victornag

  30. AndrewDon July 26, 2019 at 12:00 pm - Reply
    Your comment is awaiting moderation.

    Amazing a lot of terrific facts!

    viagra professional canada viagra vs kamagra
    viagra without a doctors prescription
    edinburgh uk viagra pages charles linskaill – https://genericviagrantx.com

    Davidmom
    TerenceMog
    Victornag

  31. AndrewDon July 26, 2019 at 12:51 pm - Reply
    Your comment is awaiting moderation.

    Nicely spoken of course! !

    jokes about viagra is viagra more effective chewed
    viagra pills
    viagra prescription cost – https://genericviagramsl.com

    Davidmom
    TerenceMog
    Victornag

  32. AndrewDon July 26, 2019 at 1:43 pm - Reply
    Your comment is awaiting moderation.

    Kudos. Quite a lot of stuff!

    mens health sreroids viagra copy viagra
    generic viagra 100mg
    viagra soft tablets – https://genericviagrantx.com

    Davidmom
    TerenceMog
    Victornag

  33. AndrewDon July 26, 2019 at 2:35 pm - Reply
    Your comment is awaiting moderation.

    Regards! Excellent information!

    how to enhance viagras effect viagra in the waters kareoke
    viagra online
    mccain viagra commercial – https://genericviagrantx.com

    Davidmom
    TerenceMog
    Victornag

  34. AndrewDon July 26, 2019 at 3:28 pm - Reply
    Your comment is awaiting moderation.

    Great info. Thanks.

    viagra vitamins viagra and generic sildenafil citrate silagra
    viagra without a doctors prescription
    viagra canadian pharmacy – https://genericviagramsl.com

    Davidmom
    TerenceMog
    Victornag

  35. AndrewDon July 26, 2019 at 4:22 pm - Reply
    Your comment is awaiting moderation.

    You explained that effectively.

    viagra passing out viagra what to expect
    viagra pills
    does viagra lose potency – https://genericviagramsl.com

    Davidmom
    TerenceMog
    Victornag

  36. AndrewDon July 26, 2019 at 5:14 pm - Reply
    Your comment is awaiting moderation.

    You reported this effectively!

    viagra beijing hours between viagra doses
    buy generic viagra
    epinephrine for viagra overdose – https://genericviagrarcp.com

    Davidmom
    TerenceMog
    Victornag

  37. AndrewDon July 26, 2019 at 6:06 pm - Reply
    Your comment is awaiting moderation.

    Thanks! Awesome stuff!

    does viagra work for mental ed viagra in woman
    generic viagra 100mg
    isosorb viagra interactions – https://genericviagramsl.com

    Davidmom
    TerenceMog
    Victornag

  38. AndrewDon July 26, 2019 at 6:58 pm - Reply
    Your comment is awaiting moderation.

    Fantastic knowledge. Regards.

    best time to take viagra viagra super active canada no prescription
    viagra for women
    rectal viagra – https://genericviagramsl.com

    Davidmom
    TerenceMog
    Victornag

  39. AndrewDon July 26, 2019 at 7:49 pm - Reply
    Your comment is awaiting moderation.

    Terrific information. Cheers.

    viagra pill uk age to take viagra
    buy generic viagra
    and viagra – https://genericviagrarcp.com

    Davidmom
    TerenceMog
    Victornag

  40. AndrewDon July 26, 2019 at 8:43 pm - Reply
    Your comment is awaiting moderation.

    Cheers, An abundance of knowledge.

    viagra low heart rate webmd viagra
    viagra online
    viagra substitute what really works – https://genericviagramsl.com

    Davidmom
    TerenceMog
    Victornag

  41. AndrewDon July 26, 2019 at 9:36 pm - Reply
    Your comment is awaiting moderation.

    Nicely put, Cheers.

    finasteride viagra interaction does viagra give you more stamina
    buy viagra
    hiden camera gay video druged viagra – https://genericviagrarcp.com

    Davidmom
    TerenceMog
    Victornag

  42. AndrewDon July 26, 2019 at 10:30 pm - Reply
    Your comment is awaiting moderation.

    Very good write ups. Thanks!

    viagra sales numbers canadas viagra number online pharmacy
    viagra for sale uk
    frequency of use of viagra – https://genericviagramsl.com

    Davidmom
    TerenceMog
    Victornag

  43. AndrewDon July 27, 2019 at 12:16 am - Reply
    Your comment is awaiting moderation.

    Regards, Fantastic stuff!

    viagra pfizer prednisilone and viagra
    generic viagra 100mg
    viagra with other drugs – https://genericviagrantx.com

    Davidmom
    TerenceMog
    Victornag

  44. AndrewDon July 27, 2019 at 2:56 am - Reply
    Your comment is awaiting moderation.

    Point clearly utilized.!

    how to buy viagra from home viagra dapoxetine
    generic viagra online
    how to break a viagra pill – https://genericviagramsl.com

    Davidmom
    TerenceMog
    Victornag

  45. AndrewDon July 27, 2019 at 3:48 am - Reply
    Your comment is awaiting moderation.

    Amazing facts. Thanks a lot!

    how much viagra to take online generic viagra
    generic viagra
    viagra money settlements in 2010 – https://genericviagrarcp.com

    Davidmom
    TerenceMog
    Victornag

  46. AndrewDon July 27, 2019 at 4:40 am - Reply
    Your comment is awaiting moderation.

    Cheers, I enjoy this!

    effectiveness of viagra viagra and cardiomyopathy left ventricular
    generic viagra online
    zenegra viagra – https://genericviagrarcp.com

    Davidmom
    TerenceMog
    Victornag

  47. AndrewDon July 27, 2019 at 5:32 am - Reply
    Your comment is awaiting moderation.

    Kudos, Useful stuff!

    viagra ordering on line enzyte viagra
    buy generic viagra
    results of using viagra – https://genericviagrarcp.com

    Davidmom
    TerenceMog
    Victornag

  48. AndrewDon July 27, 2019 at 6:23 am - Reply
    Your comment is awaiting moderation.

    You suggested that effectively!

    who invented viagra cumparare viagra
    viagra for women
    can viagra be taken by women – https://genericviagrantx.com

    Davidmom
    TerenceMog
    Victornag

  49. AndrewDon July 27, 2019 at 7:14 am - Reply
    Your comment is awaiting moderation.

    Appreciate it, Ample posts.

    viagra delivered within 24 hours viagra package insert
    viagra 100mg
    generic viagra side effects – https://genericviagramsl.com

    Davidmom
    TerenceMog
    Victornag

  50. AndrewDon July 28, 2019 at 8:22 pm - Reply
    Your comment is awaiting moderation.

    Awesome info, Cheers.

    blue moon viagra free sample of viagra for $10
    generic viagra
    for viagra – https://genericviagrantx.com

    Davidmom
    TerenceMog
    Victornag

  51. AndrewDon July 28, 2019 at 9:11 pm - Reply
    Your comment is awaiting moderation.

    Nicely put, Thanks a lot.

    berman sister female viagra study lowest price on viagra
    generic viagra 100mg
    womans backlash to viagra – https://genericviagramsl.com

    Davidmom
    TerenceMog
    Victornag

  52. AndrewDon July 28, 2019 at 10:00 pm - Reply
    Your comment is awaiting moderation.

    You said it adequately..

    all natura viagra altitude sickness viagra
    viagra generic
    does viagra cause depression or anger – https://genericviagrarcp.com

    Davidmom
    TerenceMog
    Victornag

  53. AndrewDon July 28, 2019 at 10:48 pm - Reply
    Your comment is awaiting moderation.

    Appreciate it, A lot of forum posts!

    dutasteride viagra is there a daily viagra
    buy viagra
    viagra buy – https://genericviagrarcp.com

    Davidmom
    TerenceMog
    Victornag

  54. AndrewDon July 28, 2019 at 11:38 pm - Reply
    Your comment is awaiting moderation.

    Kudos. I value it!

    publicidad viagra marketing edinburgh report search pages viagra phentermine
    buy generic viagra
    viagra for peyronie’s disease – https://genericviagramsl.com

    Davidmom
    TerenceMog
    Victornag

  55. AndrewDon July 29, 2019 at 12:28 am - Reply
    Your comment is awaiting moderation.

    You actually reported it superbly!

    anger and viagra viagra lawsuit checks in may 2010
    generic viagra
    viagra 50 mg store in canada – https://genericviagrantx.com

    Davidmom
    TerenceMog
    Victornag

  56. AndrewDon July 29, 2019 at 1:18 am - Reply
    Your comment is awaiting moderation.

    This is nicely expressed. !

    cheap online purchase viagra find sites search viagra computer
    buy viagra
    generic viagra vs pfizer – https://genericviagrarcp.com

    Davidmom
    TerenceMog
    Victornag

  57. AndrewDon July 29, 2019 at 2:08 am - Reply
    Your comment is awaiting moderation.

    You have made your point!

    altitude and viagra herbal viagra wholesale
    buy viagra
    viagra gel aka james bond – https://genericviagrantx.com

    Davidmom
    TerenceMog
    Victornag

  58. AndrewDon July 29, 2019 at 2:59 am - Reply
    Your comment is awaiting moderation.

    With thanks, I like this!

    viagra legal moves generic how to buy viagra in ireland
    viagra without a doctor prescription
    viagra title object – https://genericviagrantx.com

    Davidmom
    TerenceMog
    Victornag

  59. AndrewDon July 29, 2019 at 3:51 am - Reply
    Your comment is awaiting moderation.

    Seriously a good deal of great facts!

    viagra gold do porn stars use viagra
    viagra for women
    viagra local pickup – https://genericviagrantx.com

    Davidmom
    TerenceMog
    Victornag

  60. AndrewDon July 29, 2019 at 4:42 am - Reply
    Your comment is awaiting moderation.

    Effectively spoken genuinely. .

    best way to buy viagra viagra onlines
    viagra pills
    vasotec and viagra interactions – https://genericviagrantx.com

    Davidmom
    TerenceMog
    Victornag

  61. AndrewDon July 29, 2019 at 5:33 am - Reply
    Your comment is awaiting moderation.

    Reliable information. Many thanks.

    do i need presciption for viagra free viagra sample shipped to you
    buy viagra online
    viagra pulminary hypertension – https://genericviagrarcp.com

    Davidmom
    TerenceMog
    Victornag

  62. AndrewDon July 29, 2019 at 6:24 am - Reply
    Your comment is awaiting moderation.

    You have made your point very nicely!.

    viagra porn actors cheapest cheap viagra
    viagra without a doctor prescription
    treatment for amphetamine viagra combo – https://genericviagrantx.com

    Davidmom
    TerenceMog
    Victornag

Leave A Comment