Interdisciplinary Treatment and the Study Club Dynamic
Fostering success with collaborative patient care
Michael C. Verber, DMD
Interdisciplinary rehabilitative dental treatment requires strong patient relations paired with open, timely communication among colleagues. Because the dental industry has traditionally been characterized by isolated practitioners and small group practices, many dentists have struggled to realize the full potential of interdisciplinary teams. A structured restoratively driven study club, however, can provide a sense of fellowship and a forum conducive to interdisciplinary perspectives.
The Dawson Academy Study Club package gives groups of doctors resources to experience shared continuing education. It also provides tools and opportunities to present and treatment plan in a group environment. The Central Pennsylvania Dawson Academy Study Club serves as an example of how cooperation among colleagues can foster extraordinary patient care. The case described below illustrates the combined efforts of seven members of this study club.
Stephen Canis, DMD:
General dentist Stephen Canis shared with members of the study club a case in which he recognized signs and symptoms of occlusal disease. Initial treatment had begun, but Canis was developing a comprehensive treatment plan prior to any final restoration.
The patient was seeking to restore his posterior edentulous areas with fixed implant-supported prosthetics. The mandibular incisors, canines, and premolars and the maxillary anteriors were retained, as were teeth Nos. 15 and 18 (Figure 1). While awaiting osseointegration, Canis reflected on the case and proposed the following questions:
• What occlusal scheme best suits the patient’s mix of natural dentition and implants?
• Should the implants be splinted?
• What restorative materials should be considered?
• Would screw-retained or cement-retained prosthetics be more advantageous?
• Is the number of implants placed sufficient?
Michael Verber, DMD:
Comprehensive Examination, Records, and Functional Esthetic Analysis
After initial discussion and an implant integration period, the author was invited by Canis to see the patient at his office. With the aid of the Dawson Diagnostic Wizard™ software (www.dawsonwizard.com), they performed a complete examination of the soft tissues, teeth, muscles, joints, bone, and airway. Records taken included a facebow, models with implant analogs, photographs, and a centric relation (CR) bite registration. The models were mounted on a semi-adjustable articulator (Denar® Mark 320, Whip Mix, www.whipmix.com), and the photographs and data were entered into the Diagnostic Wizard. This software not only aids in the collection and organization of data, but also provides virtual tools to diagnose, design, and plan treatment. Its visual impact promotes patient education and case acceptance, and its online portability facilitates communication within the interdisciplinary team. The application is included with a Dawson Study Club membership.
During the exam the patient expressed cosmetic concerns related to the deterioration of existing anterior composite restorations. The patient also desired esthetic correction of diastemas and shade (Figure 2) and reported a history of bruxism.
Using the bimanual manipulation technique, the condyles were seated in CR and comfortably loaded.1 A posterior interference was noted on remaining molars Nos. 15 and 18. The interference created movement from the CR position into maximum intercuspation as characterized by a Dawson type II occlusion.2 The temporomandibular joints were quiet upon Doppler auscultation, indicating healthy, properly aligned condyle-disk assemblies.3