Brenda Johnson was a graduate of an addiction treatment program who received extensive dental treatment through the Restored Images extreme makeover program. [1] Her initial examination in 2003 found missing teeth, dental decay, periodontal disease, attrition, and compromised esthetics and function. [2] Her treatment plan included nonsurgical periodontal therapy, restorations, orthodontics, crowns, and removable partial dentures to replace missing teeth and improve her smile. [3] Over 17 visits spanning more than a year, she received these treatments which greatly improved her dental health, confidence, and quality of life.

1. Mastertrack II:
Case Presentations
William B. Williams, DMD, FAGD,
MICCMO

2. Esthetic Dentistry
Orthodontics-Crown & Bridge-
Removable Prosthodontics
Brenda Johnson
Charity Case

3. Restored Images: Extreme Makeover
Team Patient
Brenda Johnson-
Graduate of the Lucy
Hall Freedom Hall
Addiction Treatment
Program for Homeless
Women

4. Restored Images: Extreme Makeover Team
Established July 2003
• David M. Whitehead, M.D.: Southern Plastic Surgery
• Bill Williams, D.M.D.: Suwanee Dental Care
• Robert Grace, D.C.: Duluth Multicare
• Tim Lao: Sporttherapy, Inc.
• Joe & Denise Cardarelli: Joseph Michael Salon & Day Spa
• Jackie Madison: Lifestyle & Weight Mgr.
• Diane King: Registered Dietitian

5. Pre-Op Photographs: Profile

6. Initial Examination: Sept 2003

7. Medical History
• Age 49
• Tobacco use
• Obesity
• High blood pressure
• Chemical dependency
• Mental health care

8. Dental History
• Missing Teeth
• Dental Caries
• Patient Concerns
– Poor esthetics
– Speech lisp
– Wants teeth

9. Pre-Tx Panoramic

10. Pre-Treatment Photographs:
Centric Occlusion

11. Pre-Tx Photographs: Right

12. Pre-Tx Photographs: Left

13. Pre-Tx Photographs: Maxillary

14. Pre-Tx Photographs: Mandibular

15. Pre-Tx Photographs:
Difficult Phonetics

16. Pre-Tx Photographs: Repose

17. Diagnosis – Treatment Plan
• Moderate periodontal
disease
• Dental caries
• Missing teeth
• Attrition
• Scaling-Root Plane
• Restorative dentistry
• Orthodontics
• Crowns # 4,5,6,11,12
• ERA RPD Maxilla
• RPD Mandible

18. Rationale for Treatment Decisions
• Esthetics compromised:
– Missing teeth: RPD better then FPD
– Attrition: Short teeth improved with crowns
– RPD Clasps: ERA more esthetic than silver clasps
• Function compromised:
– Missing teeth: RPD replace molars / maxillary anteriors
– Implants not considered but could have been used
– Speech lisp: Improved greatly with maxillary RPD

19. Mid Treatment: Orthodontics

20. Midpoint Progress: Sept 2004
•Orthodontics completed: Jan ’04 – July ‘04
•Loss of 68 lbs and over 36 inches
•Cardiovascular and neural systems much
improved
•Smoking down from 48 to 5 cigarettes a day
•Fried chicken down from 3 pieces per day to
one or two a week
•Hair style looking very sharp.

21. Donation of Services
for Restored Images Patient

22. Post Treatment Occlusion

23. Post-Tx: Right

24. Post-Tx : Left

25. Post Tx: Mandibular

26. Treatment Completed

27. Before & After
Note the much
improved lip support
and posture

28. Before & After

29. Treatment Completed: Smile

30. Brenda Johnson: 17 Office Visits
• Initial Visit:
– Exam, radiographs,
diagnostic models
• Second Visit:
– Non-Surgical Therapy
– Restorative resins
– Orthodontic bracketing
• Third thru 14th
Visits:
– Orthodontic chain change
– Debracket
• Fifteenth Visit:
– Crown preparation
• Sixteenth Visit:
– Try in Crowns
– RPD Impressions
• Seventeenth Visit:
– Cement Crowns
– Insert RPD’s

32. The Unveiling Moment: Brenda’s Friend

33. Brenda’s First Public Smile

34. Happy Friends

35. Happy Over Her New Smile