“This 84 year old patient had been a patient of my fathers, and mine after I joined the practice, for more than 40 years. A truly wonderful person, she was diligent in having her regular check-ups and replacing restorations as needed due to excessive wear, eventually requiring cast partials and then even the replacement of those prostheses. She seemed to never be interested in doing anything different with her mouth and smile.

One day she came in with a broken tooth and I had a frank discussion with her about whether she wanted dentures as the management of her dentition was becoming more and more complex and it might give her a more natural-looking smile. I was surprised when she broke down crying and said that no one had ever asked her that question before. As we talked it came out that she loved to sing at church but was having trouble and children were frightened when she smiled which upset her a great deal. She was very happy to hear that we could create a new smile for her (that matched her inner beauty in my opinion) and decided to go ahead with a full mouth reconstruction.

K-7 diagnostic software and a TENS unit were utilized to determine her comfortable bite position. She needed a huge increase in her vertical dimension from a single digit Shimbashi number. We worked through the LVI aesthetic protocols to pick a tooth shape for her. A Diagnostic Wax-up was prepared by Aurum Ceramic/Classic, showing the patient her new smile. Once we were sure she was comfortable in her new position, we prepared her remaining upper teeth using Prep Indices, Bite Stent and Siltec Provisional Stent from Aurum Ceramic/Classic and placed a transitional partial. An LVI Bonded Orthotic and a Removable Orthotic were placed on the lower arch to keep her stabilized. A short time later, we restored her upper arch with IPS Empress crowns and a Princess PFM bridge with precision attachments, all beautifully crafted by Aurum Ceramic/Classic’s AE (Advanced Esthetic) team.

We took another Myobite to confirm her AP and vertical and then had another Diagnostic Wax-up and Temporary completed for her mandibular arch so she wouldn’t have to wear the Removable Orthotic any longer. We also remade and placed the LVI Bonded Orthotic. Once her bite was confirmed again, the lower arch was prepped and restored with IPS Empress crowns and Princess PFM bridges.

Today her eyes literally light up every time I she her. In her own words, “I never thought I’d have teeth again. I can’t stop smiling, I can eat and, best of all, I can sing again”.

- John Pawlowicz, DDS

Full face prior to treatment.	Close-up of smile prior to treatment.
Smile restored with IPS Empress crowns and Princess PFM bridges.	Full face after treatment.

Dr. John Pawlowicz graduated from the University of Pittsburgh’s School of Dental Medicine in 1993 and then completed a residency at UPMC Montefiore Hospital. He is in private practice with his father and two brothers in Lyndora, PA, concentrating on neuromuscular dentistry. Dr. Pawlowicz has completed 19 courses at the Las Vegas Institute for Advanced Dental Studies (LVI) and is currently an LVI Instructor and Regional Director. A consultant for Dentsply/Caulk, he has a Fellowship in ICCMO, is a member of the AACD, AGD and ADA and is a delegate to the Pennsylvania Dental Association.