CERECDoctors.com-Q2-2017 - page 70

68 | CERECDOCTORS.COM | QUARTER 2 | 2017
Lack of a proper airway may lead to bruxism. Certainly not as
controversial as claiming that the Earth is flat; but, in the dental
community, this is one of those things that is starting to gain trac-
tion as clinicians begin to evaluate the airway of their patients
presenting with wear.
In the Spear Educationworkshops, there is a simple yet powerful
H A P P E N I N G S I N T H E W O R L D O F C A D / C A M | | | B Y S A M E E R P U R I , D . D . S .
Communicating Airway Deficiency
Another Aspect to Consider When Treatment Planning
the world is definitely notflat. that is a fact accepted by pretty much everyone on the planet. Yet, in the big
picture of the history of this world, it wasn’t that long ago that this very fact was questioned by many. But we all know now that
science, education and acceptance have contributed to our collective understanding that the world we live in is, indeed, round.
esthetic and functional rehabilitation of their dentition.
Obviously, with the increasing evidence that lack of a proper
airway can contribute to bruxism experienced by the patient, all of a
sudden we need to reword EFSB to EFSBA. Or, should it be AEFSB
to give airway the importance that it deserves? No doubt if the
patient cannot breathe, thenwhat is the point of good-looking teeth?
Dr. Jeff Rouse, whowrote anexcellent paper calledBruxism
Triad stated at a recent lecture, why not spell “esthetics” with
an “a” — aesthetics. This way, you can include the evaluation
of the airway in your routine patient examination as AESFB.
Spear Education recently announced that Dr. Rouse has
joined the Spear faculty and will be conducting seminars and
workshops concerning this very subject.
At the end of the day, it doesn’t matter the classification
or how you actually classify it; it is an important point to
consider airway analysis and evaluation in a patient’s case
planning since lack of proper airway can play a huge role in
the destruction of teeth.
The phenomenon is simple. The airway is restricted at
night and the patient reacts by clenching or grinding in an
effort to breath. The bruxism increases oropharyngeal tone
allowing improved inspiratory flow. This repeated process of
posturing now has detrimental effects on the dentition which
historically has been restored by simply altering the teeth with a
lack of understanding of what is actually causing the wear.
Today, we can not only restore the teeth, but hopefully keep the
teeth from wearing further by assessing and addressing the airway
of the patient. SICAT Air is simply one aspect in that assessment.
Visually, it’s a powerful tool to be able to show your patient what is
happeningwith their airway and that further evaluation needs to be
done so as to not cause problems with the dentition again. Just as
we use countless patient education tools in our practices, the SICAT
Air software is yet another tool to create awareness for the patient
to understand the conditions that are affecting their oral health.
For questions and additional information, Dr. Puri can be reached
at sameer@cerecdoctors.com.
Image of SICAT Air at DSWorld; there will be lectures on airway and
restorative connection.
workflow that teaches students the importance of case planning. In
the Facially Generated Treatment Planning (FGTP) workshop, the
starting point of any case is esthetics. A simplified formula for treat-
ment planning is given to students called EFSB — Esthetics, Func-
tion, Structure and Biology. Start with the esthetics, meaning set the
upper teeth where they need to be to look good within the patient’s
mouth. Then address the function which, in this case, that would
involve putting the lower teeth in a position that occludeswell. Now
we look at structure — what materials to use is, there enough tooth
structure remaining? And finally, biology—does crown lengthening
or other periodontal work need to be completed?
Understanding this workflow has been one of the biggest
revelations for me and many others in terms evaluating and
understanding ideal treatment sequencing for patients requiring