Establish Harmonious Plane of Occlusion with Implant Replacement: Correct Procedure?
Anon. asks:
I made diagnostic casts of a new patient who wants me to replace a missing #30 [mandibular right first molar] with an implant and crown. The tooth has been missing for years. One problem is that the opposing #3 [maxillary first molar] has super-erupted and I need to do an occlusal adjustment to establish a harmonious plane of occlusion.
I explained this to the patient and she was skeptical about having to ‘grind on a perfectly good tooth’. She called her nephew in another state who graduated dental school last year. He told her that there was no reason for me to grind ‘a perfectly good tooth’ and that all the necessary accommodations could be made in the crown on #30. He told her to get a new dentist and that implants are different from natural teeth and that is why there would be no problem. What should I tell the patient and what should I do? Is my treatment plan the correct one?