The lengthening was needed to provide incisal guidance to relieve TMD symptoms.
(When moving the lower teeth forward in contact with the upper teeth, it is desirable for the
back teeth to lose contact, while only the front teeth contact. Without this type of bite, patient
had sore jaw muscles, pain in the temperomandibular joint, and sore back teeth.
Lengthening her upper incisors, produced the desired separation of the back teeth when she
moved her lower jaw forward.)

Patient had TemperoMandibular Dysfunction symptoms. In protrusion, she had posterior molar contact, related to inadequate incisal guidance. Symptoms were eliminated by wearing an NTI-tss bite-guard (see www.nti-tss.com ) at night. Now we will lengthen 1.2, 1.1, 2.1, 2.2 to provide the necessary incisal guidance. Improved aesthetics will be a secondary benefit. Talisman Dental Laboratory will make a diagnostic wax-up and a silicone putty lingual-incisal matrix, to be used in the mouth for placement of composite resin.

Upper 4 incisors (1.2, 1.1, 2.1, 2.2) received direct bonding with SE Bond, Point 4 microhybrid (shade A3 at gingival 1/3, B2 at incisal 2/3), Renamel Microfill (medium incisal), and Esthet-X (white opaque) for incisal edges of 1.1 & 2.1. A replacement NTI-tss bite-guard was fitted to protect the new restorations. Treatment was done February, 2003. Restorations are still intact, and TMD symptoms are still gone.

Comfortable, happy patient.