Blending Today’s Science with Successful Clinical Treatment Strategies OCCLUSION

With Barry Glassman, DMD

CCLUSION For predictable restorative

OCCLUSION MATERIALS PARAFUNCTION MANAGEMENT

September 15-17, 2016 The Walt Disney World Swan resort Orlando, Florida 21 Hours CE $2595. Call 941-957-0063 or visit www.ChasolenEducation.com Dear Friends and Colleagues, Without a doubt, one of the most popular and confusing topics in WELCOME restorative dentistry is the ongoing debate regarding occlusion. Occlusion has two very distinct applications in today’s dentistry. The Of special significance is the “pain/restorative disconnect”. first application is occlusion and its relationship to restorative dentistry. The second is occlusion and its relationship to TMD, facial This is the gap of connection between the TMD/facial pain pain, joint dysfunction and the reported associations with headache specialists and the reconstructive restorative . The and upper quarter pain patterns. Through case presentations and void in understanding the differences in occlusal treatment scientific literature, this one of a kind program will finally explain the modalities for patients diagnosed with a temporo- difference between these two very different yet critically important mandibular disorder/facial pain or a dentition in need of scenarios. reconstruction for dental or cosmetic reasons. In other words, what is the correlation between TMD and occlusal For years, confusion and fear have led to non-scientific and dogmatic reconstruction? Do occlusal interferences warrant philosophies. Some philosophies overzealously discuss the equilibration? Is there one particular condylar position or “correction” of the bite as a treatment for temporomandibular related vertical dimension that is best for a reconstruction? And so problems. Other philosophies overcautiously forbid the alteration of importantly, does joint or muscle pain mandate occlusal Howard M. Chasolen, DMD Barry Glassman, DMD the occlusion for needed restorative purposes even for the patient with no joint symptoms. This confusion has led many to both over- reconstruction? While this program is a must for anyone Dr. Howard Chasolen graduated from the treat and under-treat patients based on mis-information and myths wishing to become comfortable with University of Medicine and Dentistry of New advanced fixed , it is truly passed down from previous generations misusing empirical evidence Jersey in 1991. He earned a certificate The worn dentition presents a unique set of cofactors and equally essential for any dentist who wants as science. in Prosthodontics and a fellowship certificate in clinical issues requiring consideration. If one scours the to see past occlusal mythology that does Implant Prosthodontics from the University of nothing to help our patients and has truly This unique 3 day program includes a full day on evaluation, literature, there is much in the way of case presentation, Pittsburgh School of Dental Medicine from 1991 been confusing when one looks beyond the anecdote and dogma. However, a current, evidence based and to 1994. He is a Diplomate of the American diagnosis, treatment and management of the facial pain patient. The confirmation bias that occurs in our offices scientific look at the restoration of the worn dentition has Board of Oral Implantology and a Fellow of the first day of the 3 day option will develop an understanding of occlusal daily. The emphasis will be not only on American Academy of Implant Dentistry. dysthesia, internal derrangements, arthralgias, degenerative joint rarely been presented. Yet, fear and reservation remains in the occlusion for the restorative dentist but disease, ligament injuries, acute vs chronic pain, neuropathic pain and hands and minds of many clinicians with regards to topics such how to deal with odontogentic pain from a He is Past President of the Florida Academy of as the interrelationships between reconstruction and TMJ non odentogenic source, and so much headache neurobiology, pharmacotherapy and injection techniques , The Florida Prosthodontic more. for extracapsular and intracapsular disorders. issues. vertical occlusal dimension, esthetic determinants, Association and The Sarasota County Dental occlusal philosophies, articulator systems and current state of Association as well as being appointed to the On day 2 of the program, after a practical and relevant review TM joint the art in dental materials. At the forefront of the confusion are faculty at the University of Florida in the and muscle anatomy and physiology, Drs. Chasolen and Glassman will Graduate Prosthodontic Residency Program. Dr. the legendary assumed relationships between occlusal Chasolen has restored over 15,000 crowns and present a detailed and patient centered concept starting with a history interferences, occlusal wear, equilibration, reconstruction and 850 full arches. His practice is limited to and followed by a physical examination. A careful description of the resolution of TMJ and facial pain issues. This ground- Prosthodontics and is located in Sarasota, function and parafunction including pathophysiology of parafunction breaking 2-day program will answer all of today’s challenging Florida. and sleep bruxism will lead to an understanding of force vectors, questions regarding the relationships between the TMJ, patient adaptive capacity and the role of function and parafunction as muscles, teeth, parafunction and detail the evaluation, forces that threaten your patients and the dentistry you do for them. diagnosis, treatment and post operative management of the Dr. Barry Glassman was graduated from the The different occlusal reconstructive philosophies will be examined, University of Pittsburgh in 1973. After a stint in worn dentition. A foundational discussion of the anatomy, compared and contrasted. Finally it will be clear why some patients the United States Army, he began a journey to physiology and neurobiology of the masticatory system will be with malocclusion do well – and those with better occlusions (by our learn how we, as , could help our presented. It is a must for anyone wishing to become current standards) may not. patients who suffered pain and/or joint comfortable with advanced fixed prosthodontics. We hope you dysfunction. His sometimes tortuous path can attend and will look forward to seeing you in Sarasota on through continuing education experiences began On day 3 of the program, Dr. Chasolen will cover the details of occlusal with Niles Guchet, continued to the office of reconstruction. Discussing treatment planning, the relationship of the beautiful and sunny Gulf Beach. Harold Gelb, and hit a temporary destination VDO, condylar position and cosmetics, restorative considerations for with a tour through neuromuscular training with the envelope of function and parafunction, wax up parameters, A discussion on occlusal appliance theory and design will make BioRESEARCH. Finally, having his fill of the “kool temporization, articulators and understanding how to use an any dentist feel comfortable with all of the options available aid” approach to each ideology, he took the path articulator for reconstruction. A discussion on appropriate materials, today. For the first time, the wisdom and insight from to less traveled by and decided to study the science specialists practicing the art and science of occlusion unafraid and determine the true role of occlusion. the causes of porcelain and tooth fracture, occlusion and implants, Unshackled by the mythology, he began to occlusion and the advanced periodontal patient and other special to challenge the muths and focusing on two different understand that occlusion matters when teeth topics will be the most comprehensive day in today’s education. applications of the occlusion will be coordinating their efforts are occluding, and that, even continuous to combine the concepts and simplify them to make them teaching of a myth cannot make that myth a coordinated and relevant. reality. He began talking about the key role of We hope you can attend and will look forward to seeing you in parafunction as opposed to function. beautiful and sunny Orlando this fall.

Howard M. Chasolen, DMD Barry Glassman, DMD Howard M. Chasolen, DMD Barry Glassman, DMD

PROGRAM SCHEDULE Occlusion September 15-17, 2016 Program schedule may vary

Day 1- Understanding the Relationship of Pain, Occlusion and Restorative Dentistry

7:15-8:00am Registration and Breakfast 8:00-10:00am Joint Anatomy and Physiology and Introduction to the Reality of Occlusion 10:00-10:15am Coffee Break 10:15-12:00pm The Role of Function and Parafunction 12:00pm-1:00pm Lunch 1:00-3:00pm Chronic Pain vs Acute Pain / Neuropathic Pain Patterns 3:00-4:00pm Supportive Therapies for Extracapsular and Intracapsular Disorders

Day 2- Basic Sciences for Occlusion and Restorative Dentistry

7:15-8:00am Registration and Breakfast 8:00-9:00am The “Problem of the Occlusion” and the Pain/Restorative Disconnect 9:00-10:00am The Detailed Evaluation 10:00-10:15am Coffee Break 10:15-12:00pm TM Joint Anatomy /Muscle Anatomy As It Relates to Restorative Dentistry 12:00pm-1:00pm Lunch 1:00-3:00pm Philosophies of Occlusion and Function 3:00-4:00pm Philosophies of Parafunction and Sleep Bruxism As It Relates to Restorative Dentistry

Day 3- Occlusion in Clinical Restorative Dentistry

7:15-8:00am Breakfast 8:00-9:00am The Restorative Workup , Analysis and Diagnostic Records 9:00-10:00am Condylar Position, Vertical Dimension, Anterior Guidance and Aesthetics 10:00-10:15am Coffee Break 10:15-11:00am Diagnostic Wax-Up / Mandibular Movement & Setting Your Articulator 11:00-12:00pm Managing the Occlusion With Provisional Restorations 12:00pm-1:00pm Lunch 1:00-2:00pm Managing Anterior Wear, Posterior Wear, Deep Bites, Open Bites and Complex Occlusal Presentations 2:00-2:30pm Restorative Materials for Wear Cases 2:30-3:30pm Occlusal Considerations for Fixed and Removable Implant Reconstructions, Advanced Periodontal Conditions and the Shortened Dental Arch 3:30-4:00pm Occlusal Appliance Theory and Design for Restorative Dentistry and Dealing With Ongoing Issues

Learn a simple, predictable & evidence based process to MANAGE the worn dentition.

 Learn the etiologies of wear and when restoration vs. conservative management is indicated.

 Learn how cosmetics drives the restoration of wear and how to determine the precise cosmetic position to build your reconstruction.

 Understand the complete relationship between TM joint and muscle function, anatomy, physiology, neurobiology and the worn dentition.

 Learn how to determine the inter-relationships of vertical dimension of occlusion, cosmetics and the restoration of the worn dentition.

Finally, a program that eliminates the anecdotal dogma that has guided our profession. Master the philosophies of occlusal reconstruction and the issues that go along with it.

 Become confident with detailing wax up specifications and learn how to transfer that information to the provisional prototype.

 Hear the evidence that makes it clear that neither the elimination of occlusal interferences or the alteration of the patient's bite or jaw position is necessary for the resolution of TMD symptoms. Learn how to specifically treat the patient with "bite discrepancies" who is not otherwise in need of reconstruction.

 Understand the instrumentation required to reconstruct wear cases including articulators and facebows.

 Learn how to customize a physiologic occlusion that respects the envelope of function and parafunction as well as condylar influences.

 Learn the records, photos and documentation to precisely communicate to the lab.

Learn how to treat every type of wear case…horizontal, vertical and combination wear. Diagnosis and Treatment Planning

 Detail the new patient experience and learn why the initial experience CAN’T be in a dental chair.

 Learn the steps in a comprehensive examination and how to organize your thoughts when you see a patient with extensive tooth wear.

 Understand the progression of wear and the consequences of leaving wear untreated.

 Is there a relationship between worn dentition and TMD? We will dispel the dogma and review the science.

 Understand the role of the craniomandibular system and why it does NOT start in the joints.

 How to relate cosmetics and wear in your treatment plans…. The influence of incisal edge position, occlusal plane, vertical dimension and compensatory wear and eruption.  Understand all the current reconstructive philosophies and which ones fit your patient specifically.

 Learn the anterior and posterior determinants of reconstruction. The rules for understanding when anterior guidance or condylar pathways determine the occlusal design.

 Understanding parafunction: Sleep bruxism and daytime parafunction and how it affects wear and reconstruction.

 Do occlusal interferences need to be equilibrated? Understand the relationships between occlusal interferences, parafunction, wear, TMD and the value of equilibration.

 Cosmetic planning and the worn dentition.  Learn how to select an articulator for reconstruction cases.

 Learn a quick and simple algorithm to determine if your patient’s joint is safe to proceed with reconstruction.

 Joint sounds? Episodic locking. Clicking. Stable joint? Degenerative joint and condylar resorption? Learn to incorporate this information into your restorative plan so you never have to guess at the long term effect the joint will have on your reconstruction.

 What is the relationship of occlusion to headache? (It’s not related to anterior temporalis hyperactivity)

 Understand the peripheral mechanisms of bruxism and why a bite adjustment won’t stop the grinding.

 Exam forms, informed consents, treatment plans and treatment reports for your patients.

 Learn to compose the exact documentation to educate your patient and protect you from future problems with large reconstructions. Treatment

 Learn how to synchronize the information from the aesthetic and occlusal evaluation to detail the appropriate specifications for a diagnostic wax up.

 Apply the “Complete Denture Set Up” philosophy and understand how cosmetic tooth position is integrated with function and parafunction to drive the determinants of a fixed reconstruction.

 Learn the techniques and philosophies to deprogram and register bite records for preliminary blue print wax ups.

 Understand how to select a condylar position for reconstruction.

 Learn why many authors have scared us about vertical dimension and what the real science tells us about Blending aesthetic and occlusal parameters is THE how to select or alter VDO and its relationship to pain single most important skill to learn in order to plan and wear. a reconstruction of worn dentition.

 Detail the process of creating a new occlusal scheme through temporization.

 Understand the appropriate sequence to temporize and how to schedule patients for such major occlusal changes. Pre-operative worn dentition

 Learn when an interim occlusal appliance is necessary and when the provisional restorations will serve the purpose.

Temporized and completed at a new vertical dimension

 Understand static occlusal contact design to minimize ceramic fracture.

 Learn how to program disclusion patterns and how to determine disclusive pathway angles.

 Anterior guidance? Anterior group function? Is it okay to pick up a premolar or more in working excursions? Treatment

 Learn the work flow of complex ortho, perio, restorative and cosmetic cases.

 Restoring class 1, class 2 deep, class 2 anterior open bite and class 3 occlusions.

 Understand the decision  Learn 8 things to help prevent process in restorative material porcelain fracture on your new selection for the bruxing restorations. patient. Zirconia? Emax? Is PFM or full gold still a good choice? A thorough review of the literature on material success as well as my own personal experience in restoring over 750 full arches.

 Restoring anterior wear with no posterior wear

 Restoring posterior wear with no anterior wear

 Learn what to do when there is no anterior guidance

 Understanding horizontal and vertical patterns of parafunction..

 Constricted envelopes? During function or parafunction and where to place the “freedom” component? Anterior cingulums or posterior occlusal surfaces?

 Learn when to crown lengthen, when endo, when to increase incisal edge based on cosmetics and vertical all based on lip at rest image.

 Gain confidence in restoring mechanical and chemical wear cases.

 Determining when horizontal wear requires a change in vertical dimension to safely restore. Special Topics

 Parafunction and the periodontally involved patient. Is occlusion a cofactor that exacerbates tooth loss in the presence of periodontal disease? What occlusal philosophy is best and is splinting indicated?

How to control occlusal/parafunctional forces on splayed and weakened periodontally involved teeth.

 Parafunction and the implant reconstruction. Is the implant patient at risk when parafunction is an issue? We will explore the science, our clinical experiences and propose an algorithm of treatment strategies to address this critical topic.

 Do we need molars? Is posterior support a scientifically validated requirement for healthy TM joints? This topic is critically important in periodontally involved patients as well as implant patients considering extensive posterior bone grafting to facilitate posterior implant placement. An extensive literature review will answer these questions.

Management

 Post operative management of bruxism  Post operative management of ceramic fractures.

Who is responsible?  How to deal with the patient that always needs an adjustment.  Creating appropriate patient expectations. How long should the reconstruction last and what is a reasonable approach to the inevitable replacement  Dealing with positive occlusal sense. of ceramic dentistry?

 A complete review of habits to avoid.  Parafunctional control- the Occlusal Appliance  Are there specific dietary contra-indications? We will  Full coverage appliance? Tanner? Anterior discuss this in detail. stop only? NTI appliance? Anterior repositioning? Soft guard? Bi-laminar guard? Which is right for your patient and learn the science about joint loading and appliance types.

 The pharmacologic management of parafunction. The what and when of meds. Travel & Accommodations

LOCATION THE WALT DISNEY WORLD SWAN RESORT 1500 Epcot Resorts Blvd. Orlando, Florida P: 800-227-1500 www.swandolphin.com Ask for the “Chasolen Dental Group Rate”

Reserve your room now to ensure your accommodations during peak season at Walt Disney World Swan and Dolphin Resort.

AIR TRAVEL

Orlando International Airport (MCO) www.orlandoairports.net

ACTIVITIES In the heart of the Walt Disney World® Resort, the award-winning Walt Disney World Swan and Dolphin Resort is your gateway to Central Florida’s greatest theme parks and attractions. The resort is located in between Epcot® and Disney’s Hollywood StudiosTM, and nearby Disney’s Animal Kingdom® Theme Park and Magic Kingdom® Park. Come discover our 17 world-class restaurants and lounges, sophisticated guest rooms with Westin Heavenly Beds® and the luxurious Mandara Spa. Enjoy five pools, two health clubs, tennis, nearby golf, and many special Disney benefits, including complimentary transportation to Walt Disney World Theme Parks and Attractions, and the Extra Magic Hours benefit. Registration

Occlusion for Restorative Dentistry September 15-17, 2016 tuition Walt Disney World Swan Resort Orlando, Florida

$2595. Dentists and Technicians

$1195. Staff

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Call: (941)957-0063 Ask for Maryellen Fax: (941)957-0424 Mail: 2033 Wood Street Suite 125 Sarasota, Florida 34237 Email: [email protected] Visit www.ChasolenEducation.com

All seats are guaranteed with payment. Payment in full is needed to hold the seat for the program. Cancellation Policy: Full refund less $100. administration fee if cancelled earlier than 30 days prior to the program. If the cancellation is within 30 days of the program, no refund will be given but tuition may be applied to a future seminar.

The Chasolen Education & Research Center, P.A. has been designated an approved Program Provider by the Academy of General Dentistry. This Program Provider's formal CDE programs are accepted by the AGD for membership maintenance, Fellowship and Mastership credits. The current term of approval ends on 2/28/2020. Upcoming Programs…… 2016-2017 WWW.HOWARDCHASOLEN.COM

Restorative Excellence October 21-22, 2016 $1895. ______

Implant Prosthetics March 10-11, 2017 $1895. ______

Total Case Management June 9-10, 2017 $3750. ______

Visit www.ChasolenEducation.com for registration forms and details Or call Maryellen 941-957-0063

To Register or for more information, call Maryellen 941-957-0063. Or visit www.chasoleneducation.com