Implant restoration options w/ re-establishment of VDO?

Last Updated October 27, 2014

We have a patient in our practice that had a dozen implants placed by a recent dental school graduate who has since been deployed by Army (what I have been told). I have attached a couple of clinical pictures for your review. Its been 5 months and patient wants to “get teeth asap” . While I am trying not to demean our young colleague, it looks like he forgot the cardinal rule in implants or dentistry per se: To visualize final restoration before planning any dental procedure. I would love to hear your valuable input on how to go about this case.

Almost all implants are supracrestal, the patient is not wearing any prosthesis and appears to have a loss of vertical dimension of occlusion (VDO) w/ moderate attrition in the anterior region. I am thinking of GBR-vertical augmentation in hopes to resolve the supracrestal issue. In my restorative plan, I am considering re-establishment of VDO w/ interim prostheses and anterior composite buildup, individual Cement-Retained Crowns #10,11 ; and possible splinting and using Screw retained crowns #12,13. Also I have not dealt with insurance for such procedures, I would greatly appreciate if someone could walk me through the CDT codes that can be used for re-establishing VDO and if they can be used in conjunction w/ interim prosthesis. I do sincerely apologize for lack of radiographs and substandard clinical images for your review. I will most definitely follow up with better images and radiographs when I see the patient in the next visit for a thorough consult. I would like to extend my gratitude to the valuable members of this forum for their support.

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