"This patient was concerned about the yellow appearance of her teeth that did not resolve with bleaching. She also wanted her left canine "not to stick out" and to fix the chipping in her anterior teeth. While I had asked her to be my case for the LVI Advanced program, it soon became apparent she was suffering from neuromuscular problems and required full mouth reconstruction. During discussions with the patient, she mentioned that she was having difficulty turning her head and suffered headaches in her temple. Her bilateral posterior cross-bite with a left lateral deviation of 1.1 mm stimulated a clenching issue as well.

To accomplish her treatment, the case was completed in stages. In Stage 1, a root canal and glass fibre tooth build-up was completed on tooth 2-3 in my office in Calgary. Her upper anterior teeth (1-4 to 2-4) were prepared during the first part of the course at LVI and temporized. Gingival adjustments were also made during this session using a diode laser. Back in my office in Calgary, over the two week interlude before the upper anterior placement session back in Las Vegas, I prepped and temporized her remaining upper posterior teeth (1-5 to 1-7 and 2-5 to 2-7) and placed a bonded orthotic crafted by Aurum Ceramic/Classic on her lower arch. Aurum Ceramic/Classic quickly created IPS Empress restorations for her upper posterior teeth, which were bonded in place prior to returning to LVI.