The Big Picture
Introduction to the course, aims and objectives.
Treating the whole patient – principles of holistic dental care and what this means
How to develop the tools to successfully treat every case that comes into your practice regardless of the complexity.
Understanding “conformative” and “reorganised” dentistry
Controlling multidisciplinary cases in simple steps to establish predictable results.
The mandatory and consistent use of magnification, illumination and photography.
The Objectives – applying basic principles to full mouth approach
Understanding the importance of temporomandibular joint health and function.
Understanding centric relation based full mouth case planning
Understanding “System 2 thinking” and “Stepping Stone” concepts during full mouth rehabilitation
Understanding the principles behind longevity and predictability of full mouth dentistry for the long-term benefit of the patient.
The Preparation – how do you go about reconstructing and restoring patients’ dentitions present with extensive problems on healthy foundations?
Full mouth treatment planning utilising principles learned in modules 3 and 4
Principles of conformative versus reorganised approach to dental restoration
Occlusal, aesthetic and functional planning following disease control
The use of orthodontics and orthognathic surgery to optimise tooth positions and jaw relationships
The “Stepping Stone” – advanced decision-making in restorative dentistry and how to plan every single step of basic to complex cases without surprises for the dental team or patient and how to communicate this to the patient.
Ensuring realistic time and cost allocations for these steps
Optimising the foundations of short and short and long-term dental stability:
periodontal and endodontic prognosis and maintenance
use of key teeth for stabilisation during provisionalisation
setting gingival levels and soft tissue management around teeth
the use of dental implants and the principles of bone and tissue augmentation introduction.
Laboratory communication – aesthetic, occlusal and restorative treatment planning and the functional envelope. Getting in sync with your technician.
Diagnosis and management of temporomandibular joint dysfunction and 7
occlusal disease
Working with your laboratory to establish a clear working protocol for all cases
preliminary impression and record taking for patient analysis
laboratory manufacture and presentation of preliminary patient records
temporomandibular joint dysfunction, diagnosis, the use of MRI for TMJ disease and the use of deprogrammers and occlusal splints
occlusal analysis and equilibration
diagnosis of occlusal pattern – interferences, guidance, restricted envelopes, parafunction, tooth wear, abfraction, bruxism, anterior and posterior open bites and the establishment of the correct occlusal vertical dimension
understanding the principles behind the design and use of occlusal appliances for the management of various occlusal and temporomandibular joint disorders
o the rationale for orthodontics and orthognathic surgery in preparation for restorative dentistry
o understanding digital and analogue design of dental anatomy within envelope of patient function
o having a protocol for aesthetic, functional and phonetic evaluation and the importance of airway maintenance
• Planning for maintenance and critical evaluation and monitoring of long-term success
The Method – how do you go about reconstructing and restoring patients’ dentitions present with extensive problems on healthy foundations?
Understanding the importance of occlusal analysis and properly articulated study models before any restorative case, even for one tooth.
Turning the taking of impressions and correct bite relationship records into an everyday practice event.
Understanding the principles of deprogramming and equilibration and when they should be carried out.
Understanding the importance of the use of MRI to diagnose temporomandibular joint disorders before any restorative or orthodontic treatment.
Understanding centric relation and its importance in planning predictable dental care.
Understanding the occlusal envelope and functional movements of the mandible when redesigning occlusal schemes.
Practising techniques of record taking and occlusal analysis so that they become routine for most patients.
Understanding that orthodontics is a part of restorative dentistry.
Understanding the relevance of orthodontic planning on articulated models and the need for post-operative occlusal analysis and equilibration following orthodontic treatment.
Understanding when orthodontics and even orthognathic surgery may be indicated to establish a correct occlusal relationship and function as part of restorative dentistry.
Learning how to set occlusal vertical dimension in cases with tooth wear or occlusal collapse
Understanding the importance of selecting key teeth as reference points to maintain a stable occlusion and occlusal relationship during treatment.
Understanding and planning the sequence of tooth preparations, provisionalisation, sequencing bone and tissue regeneration and implant placement, and when there is the need for more than one set of provisionals.
The importance of isolation and rubber dam when preparing for bondable restorations.
How to use retraction cord.
Utilising the “Stepping Stone” method of step-by-step planning for transitional cases to ensure that the patient always leaves the practice with functional and aesthetic provisional restorations.
Understanding when chairside provisionals versus laboratory made provisionals are appropriate
Understanding when you can be certain that you have occlusal stability prior to proceeding with final restorations.
Understanding how to communicate complex treatment plans to patients whilst keeping them onside and avoiding “treatment fatigue”
The importance of final tooth preparation refinement before impression taking and ensuring that your full mouth impressions are perfect every time.
Options and tips for taking conventional and digital dental impressions in mixed cases involving implants, overlays, full coverage crowns and veneers.
Understanding laboratory communication and setting protocols for shade, shape, texture and personalisation of laboratory work.
Removal of provisional restorations and preparation of teeth for bonding/cementation.
Bonding and cementation of laboratory work.
Understanding how and why restorative work fails and building in options for easy retrieval.
Understanding how you can place guarantees on your work to a reasonable level
Setting clear terms and conditions – revisiting your medicolegal obligations and setting clear boundaries and conditions of responsibility for maintenance of advanced restorative work with your patients in advance.
Course structure, timetable and content detail
Day 1 – Principles of full mouth approach to dental care
08:30 Registration
9:00 Lecture 1: Dr Koray Feran: Introduction of course module and establishment of key principles of full mouth approach to dental care
10:15 Coffee break
10:45 Lecture 2: Dr Koray Feran: Principles of occlusion I – The principles and determinants of occlusion and its importance across all disciplines. The temporomandibular joint, examination, diagnosis and management of temporomandibular joint disorders
12:30 Lunch
13:30 Lecture 3: Dr Koray Feran: Principles of occlusion II – Centric relation, mutually protected occlusion, envelopes of movement, muscles of mastication, occlusal analysis and examination, diagnosis of occlusal disease.
14:45 Coffee break
15:15 Lecture 4: Dr Koray Feran: Principles of occlusion III – Steps for establishing correct jaw relationships and understanding occlusal interferences, principles and design and use of deprogrammers / occlusal appliances.
17:00: Questions
17:30 End
Day 2 – Occlusion, orthodontics, skeletal development, airway and the importance of imaging. Addressing advanced temporomandibular joint and orthodontic and orthognathic issues
08:30 Registration
9:00 Lecture 5: Dr Biju Krishnan / Dr Moira Wong / Dr Asif Chatoo: Modern orthodontics in the management of skeletal growth, occlusal and airway development, and an orthodontists view of how orthodontic treatment can benefit multidisciplinary cases.
10:15 Coffee break
10:45 Lecture 6: Dr Biju Krishnan / Dr Moira Wong / Dr Asif Chatoo: Modern orthodontics in the management of skeletal growth, occlusal and airway development, and an orthodontists view of how orthodontic treatment can benefit multidisciplinary cases.
12:30 Lunch
13:30 Lecture 7: Dr Kevin Lotzof: MRI imaging and diagnosis of temporomandibular joint disorders
14:45 Coffee break
15:15 Lecture 8: Dr Luke Cascarini: A surgeon’s eye view of temporomandibular joint disorders and what happens when existing temporomandibular joint dysfunction is very advanced and conservative management has limited success
17:00: Questions
17:30 End
Day 3 – Occlusal records and laboratory planning
08:30 Registration
9:00 Lecture 9: Dr Koray Feran: Principles of occlusion IV – taking of jaw relationship records, laboratory mounting of articulated casts, occlusal analysis and equilibration, occlusal planning and laboratory design of occlusion.
10:15 Coffee break
10:45 Lecture 10: Dr Koray Feran: Principles of occlusion IV – taking of jaw relationship records, laboratory mounting of articulated casts, occlusal analysis and equilibration, occlusal planning and laboratory design of occlusion continued.
12:30 Lunch
13:30 Lecture 11: Dr Koray Feran: Preparing for provisionalisation I. Pre-operative evaluation and patient communication. Multidisciplinary sequencing of preparatory stages – occlusal stabilisation, orthodontics, planning for laboratory made provisional restorations
14:45 Coffee Break
15:15 Lecture 12: Dr Koray Feran: Preparing for provisionalisation II. Multidisciplinary sequencing of preparatory stages – occlusal stabilisation, orthodontics, planning for laboratory made provisional restorations. Allocating sufficient time for transition from current to new occlusal relationship on provisionals.
17:00 Questions
17:30 End
Day 4 – Practical record taking, model articulation, occlusal analysis
08:30 Registration
9:00 Full day practical for delegates to carry out occlusal examination, occlusal records, articulate their own study models, come to a diagnosis and carry out photographically documented equilibration where appropriate to understand the principles.
17:00 Questions:
17:30 End
Day 5 – Understanding full mouth preparation sequencing
08:30 Registration
9:00 Lecture 13: Dr Koray Feran – Full mouth preparation. Preliminary conservative preparations to allow provisionalisation and use of silicone indexes and differential digital scans to understand space requirements and minimise tooth loss.
10:15 Coffee break
10:45 Lecture 14: Dr Koray Feran – Principles and armamentarium for tooth preparation, different preparation designs for overlays, crowns and veneers and provisionalisation
12:30 Lunch
13:30 Lecture 15: Dr Koray Feran – Principles and armamentarium for tooth preparation, different preparation designs for overlays, crowns and veneers and provisionalisation
14:45 Coffee break
15:15 Lecture 16: Dr Koray Feran – Refinement of preparations and taking of definitive impressions and jaw relationships for final laboratory work.
17:00 Questions
17:30 End
Day 6 – Laboratory stages, communication, fitting and finalisation
08:30 Registration
9:00 Lecture 13: Dr Koray Feran – Prescription of laboratory work, use of photographic presentations for laboratory communication, completing laboratory dockets and liaising with laboratory on final design of laboratory made restorations.
10:15 Coffee break
10:45 Lecture 14: Dr Koray Feran – Critical checking of laboratory work and preparation for fitting in advance of fit appointment.
12:30 Lunch
13:30 Lecture 14: Dr Koray Feran – Removal of provisional restorations, try in and verification of laboratory work and importance of patient feedback and acceptance. Bonding and cementation of final laboratory work.
14:45 Coffee break
15:15 Lecture 14: Dr Koray Feran – End of treatment review appointment to finalise occlusal adjustments, functional excursions and take baseline photographic radiographic and digital scanning records for commencement of guarantees. Assessment of requirement for end of treatment occlusal protection and ensuring patients understand their responsibilities for examination and hygiene attendance for future guarantees. Predicting and addressing failures.
17:00 Questions
17:30 End
