Adjunct Professor

School of Clinical Dentistry

Ronald G. Presswood

Lorraine S.

Five years of pain and obsession. Three restorative events,

numerous splints.Asked us to make a splint afteralmost a year of observation.

Previous Splints, Five Years

Current Max Anterior RP. Teeth do not fit together .

Failed Restorations, UR

Crowns requiredExtensive Adjustment.Often Came Uncemented

Initial Seat, PGA, Pain R

Which contacts stimulate pain on the right?

1st Adj, much better, 11/8/05

Why?

This guide supports R TMJ.

Resurface Posterior, 11/15/05

One week after initial placement.

Why do you thinkthis was done?

Add the balancing guide!

Resurface Posterior, 11/15/05

What did we gain?

1st Adjustment, 11/15/05

3rd Adjustment, 11/15/05

Anything wrongon the splint?

4th, Final Adjustment, 11/15/05

Initial Check, Sore R, 11/21/05

Why isshe sore on the right?

Could it be anAnterior GuideIssue?

1st Adjustment, OK, 11/21/05

Done Yet?

NO!!!

What’s the issue?

2nd, Final Adjustment, 11/21/05

Are you looking at the ink, or the streak.

Initial mark, #4 “soft”, 11/28/05

Upper Bi istender to percussion and 1+ mobile.

How did weget this marking??

Why did we want it?

2nd mark, #4 better, 11/28/05

Anything elseget yourAttention?

3rd mark, all ok (OK?), 11/28/05

Is this splintOK for patient to leave?

What about 10, UL 2

and 12, UL 4?

Initial mark, Pain R, 11/30/05

Pain on rightkeeps comingback.

What do you thinkis changing?

Could a muscle be releasing?

Or, could a joint be healing? Inflammation goingaway?

Why are the markings so small?

Almost complete, one last thing

Slight discom-fort on right.

What do you think is causingthe problem?

What you think about havingonly 2nd molarcontacts?

Initial Mark, Feels Good, 12/5/05

Light Tap

=

MIP

3rd Adj., R click, 12/5/05

Why is therea right click?

What marksare involved?

What instru-ment is used to removethe contact?

3rd Adj., No click, 12/5/05

So, whichcontactsdid we remove?

Which Tooth Contacts Are Bad?

Whichcontacts,in whichorder?

Which Tooth Contacts Are Bad?

Whichcontacts,in whichorder?

Relievedon maxillaryteeth

BalancingGuides

Noxious Guide on Bicuspid

Balancing Guides Are Protective

Balancing guide maintains mutualcontact.

Working guide progressively isolates inclines and “rocks” the teeth.

Balancing GuidesAll the

same radius

OA to soften the guide

Muscle Pain R #2, 12/15/05

What’stheIssue?

5th, final, adjustment, 12/15/05

Any bad Contacts?

What are these?

Initial Mark, Feels Good, 3/1/06

From Dec. 15 until March 1, she was seen weekly.

MUSCLE AND JOINT HAVE NOT BEEN A MAJOR ISSUE SINCE JANUARY.

Any unhealthy contacts?

Initial Mark, Feels Good, 3/1/06

Same Marks, Different Perspective.

Where are thebad ones?

Use of personal photographs

Dear Dr. Presswood, Yes, you have my permission to display the two photos taken of me whileunder your care. I wish you continued good work with your clinical studies, which I hopewill be able to help more people- just like you have helped me. Because of you and your care, I now have a better quality of life. Sincerely, Lorraine S

6 November 2009

Pre and Post Photos, 6 Months

12/2006

05/2007

Attending Doctors

NeurologistInternistPhysical TherapistDDS, PhD, Pain Specialist

Ron Presswood, General DentistWho is doing the better job from

the patients perspective?

Why do you think that?

Dear Dr. Presswood,

I hope that your summer is progressing well and that you and yours aredoing fine!

I am writing to tell you that in six years time, I am having the bestsummer since 2001!!!!!

I have reduced my Gabapentin by 100 mg. to a total of 800 mg. daily.  Ihave had some "bad days", but nothing compared to the past.  I wear mysplint 24/7 and only take it out to eat.  I can tell that my  "bite" isnot firm or sound, but while wearing the splint........... it is solid. My muscles seem to have calmed down quite a bit with all of the splintadjustments that you made Nov. -May.

This is the first time in six years that I am anxious to return toHouston.  I will call Lisa to make an appt. so you can slowly start toadjust my bite on my real teeth!  I am optimistic that you can help meeven more.

I don't know how to begin to thank you.  You have made such a differencein my life -all for the better.

George, Abby and I are having a record September for visiting houseguests -friends and family.  We love having company visit, since we'regone from Houston so much.  Also, our friends like to get "out of theheat"!

I never did actually invite you, but you and your wife are always welcometo come to the mountains and visit us here -(Sept. is "booked"!!!)  MaybeOctober?

Please give Lisa and Julie my best.  I will see you all in November forsure.

Sincerely and with heartfelt thanks,

Lorraine S., August 31, 2006

Thanks for your attention!!