218. Darin Ditcher, DMD - Fixed vs Removable Solutions for the Edentulous Arch
Apr 10, 2024
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Dr. Darin Ditcher, DMD discusses transitioning from removable to fixed dental solutions, navigating dental literature for edentulous patients, classification systems, prosthetic designs, patient photography, and balancing technical skills with psychological care in dentistry.
Visualizing lip movement is vital in fixed cases post-extraction to ensure optimal tooth position.
The LIP Tooth Ridge classification system aids in making informed prosthetic decisions based on tooth and ridge relationship.
Deep dives
Managing Tooth Position and Lip Movement for Fixed Reconstructions
When considering fixed cases after tooth extraction, determining the optimal tooth position and assessing lip movement are crucial. By encouraging patients to laugh or perform exaggerated smiles, clinicians can visualize where the lip naturally goes. Understanding the flange requirement for lip support and checking if a fixed reconstruction is viable without compromising lip aesthetics is essential.
Challenges Faced in Prosthodontics Education
Prosthodontics education can present challenges, especially in understanding the nuances between different prosthetic designs. Clinicians often struggle with comparing treatment approaches and making informed decisions. The lack of clear guidelines in classifying and synthesizing information leads to uncertainty in treatment planning.
The Impact of LTR Classification on Prosthetic Decision-Making
The LIP Tooth Ridge (LTR) classification system has revolutionized prosthetic decision-making processes. By categorizing patients based on their tooth and ridge relationship, clinicians can make more informed decisions. LTR classes help in determining the need for a flange, distinguishing between white and pink prosthetic components, and selecting appropriate prosthetic designs.
Navigating Patient Psychology and Expectations in Prosthodontic Care
Effective patient management in prosthodontic care requires not only technical expertise but also strong communication skills. Clinicians must listen attentively to patients' stories, understand their psychological challenges, and set realistic expectations. Balancing between painting a clear picture of the prosthetic outcomes and avoiding overwhelming patients with too much information is key to successful treatment outcomes.
Dr. Dichter brings nearly 20 years of clinical, research and teaching experience — as a general practitioner and prosthodontist — to his position with Spear. He serves as an instructor in the Treating the Terminal Dentition and Fully Edentulous Patient seminar, in addition to multiple Spear Workshops.
Dr. Dichter has served as a guest lecturer and clinical instructor at Oregon Health and Science University School of Dentistry, teaching occlusion and esthetics. He has been a Spear faculty member since the company’s inception, as well as a contributing author for Spear Digest. He is passionate about education and is involved with multiple study groups in the U.S. and Canada.
After earning his D.M.D. from OHSU in 1995, Dr. Dichter practiced general dentistry and eventually joined a startup practice in his hometown in coastal Oregon before moving to a practice in Portland. He brought 16 years of restorative dental experience into UCLA’s world-renowned, full-time advanced prosthodontics residency, which he completed in 2014.
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