Age – related wear is normal, whereas pathologic wear may result from parafunction as clenching and grinding. The purpose of canine guidance and canine protective occlusion is to disocclude the anterior and posterior teeth, as canine wear progresses the posterior teeth begin to contact in lateral movement and are more prone to symptoms of tooth overload.

The anterior teeth ( specially the laterals) can also become notched and worn.

Improving canine guidance will protect posterior teeth and prevents incisal edges of front teeth from breaking or chipping.

A supportive nightguard is recommended to protect restored dentition.

Cuspid Rise or
Cuspid protected occlusion.

Should I be concerned
-Yes! – If you see wearing of the enamel of incisal edges of your front teeth.

-19 years old patient noticed wearing of the edge of her right front central tooth.

Slanted edge of right central.

Lack of proper contracts of upper and lower cuspids during lateral movements of lower jaw to the right and left side. Central and lateral are touching.

Composite build-up on upper right cuspid and lower left cuspid allowed proper separation of upper and bottom teeth in lateral movement of the lower jaw. Upper central restored.

After compromised orthodontic treatment

No contact on cuspids
incisal edge worn down

X-Bite correction without orthodontic treatment

Upper right cuspid is in X-bite with lower cuspid. Lack of cuspid protected occlusion lead to damaging of front teeth.	The first step to restore smile is to rebuild cuspid, so the incline plane of this tooth will dissipate forces of chewing away from the front teeth.
Finally lateral and central incisors can be restored by using bonding and composite material. The Night guard was fabricated to protect teeth from grinding at night.

Seven years after the restoration. The bite and esthetic are very good!

• MK Pontic Procedure
• Cantilever Bridge

• Congenital malformation
• Sports injury
• Carries and root fracture
• Periodontal diseases

Every patient with missing tooth is given all the options of replacing it.
The ‘MK Pontic’ is a unique treatment option used to replace a missing tooth that does not require reduction of adjacent teeth. While not available for all cases it can offer tooth replacement that is both cost effective and minimally invasive. This treatment has been developed by Dr. Klimek and has been a very successful since 1984. This restoration is easily reparable and is the most conservative approach for single tooth replacement.
Every patient with missing tooth is given all the options of replacing it.

“MK Pontic” my first restoration in 1985

After orthodontic treatment June 1994

Congenitally missing lateral incisor

MK Pontic after 10 years in patient mouth

MK Pontic after 10 years.
Composite tooth was formed and attached by bonding to intact enamel of adjacent teeth.

Congenitally missing lateral incisors

“MK Pontic” and composite restoration performed in 1994

Sometimes patient has only one missing tooth but one of the teeth adjacent  to space is weakened by large filling placed after root canal treatment done previously and needs full coverage by a crown.

In this clinical condition Dr. Klimek presents patient with treatment options :

1. Crown over the weak tooth and implant to replace missing tooth.
2. Conventional Bridge Two abutments and one pontic for missing tooth.
3. Cantilever Bridge with splint.

The Cantilever Bridge with a splint was designed and improved over the years by Dr. Klimek and has been very successful for over 16 years.

This is formed by a pontic (artificial tooth) attached to the crown on one side and supported by a metal loop embedded in the adjacent tooth by the use of composite bonding. Only one of the teeth adjacent to the gap needs to be prepared for the crown.

Those patients had one congenitally missing tooth and the tooth next to the space needed a crown.
The Cantilever Bridge with composite splint was conservative and successful restoration.

Multidisciplinary treatment: orthodontic, porcelain veneers, bridges.