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March / April 2018

Advances In Prosthodontics TM

New Findings & Best Practices for Cosmetic & Restorative Dentistry

Do You Have a Patient Who


INSIDE THIS ISSUE Is Frustrated With Their
Removable Denture?
CASE SUMMARY:
Do You Have a Patient
With This Situation?
(see photos on right)

Complete Details
on this Maxillary
Reconstruction…
pages 1-3

HAVE A LAUGH:
Denture-Inspired
Phone Cover…
page 3

COMPLEX CASES:
Drs. Scruggs and Molina
Have Training & Experience
That Make These
Treatments More Here’s the story of a patient who was referred from
Successful... another dental professional...
page 4 If you have a patient with several missing, broken or worn teeth, they may be a
candidate for a oral reconstruction with the assistance of a Prosthodontist.
© Sams Media Group, LLC
Read more on the next page…

Do you want another opinion on a complex case? Or to meet and share ideas?

There are many ways we can help each other by working together on complex cases and by sharing
knowledge and experience.

With your reputation for quality dental care, and my experience with restorative treatments, we can work
together on advanced cases and both benefit!

If you'd like to meet to discuss a treatment, or talk on the phone about how we can help each other,
please call or email my office with specific days and times when you’re available to talk or meet.

Dr. Bill Scruggs, Prosthodontist ! Specialist in Complex Care ! 919-623-0294 (cell) ! DrBillScruggs@NCprosthodontics.com 1
FROM THE PROSTHO FILES

CASE SUMMARY: Maxillary Full-Arch Reconstruction


by Bill Scruggs, DDS, MS, Prosthodontist

Patient “Paul” was referred to me due to his complex dental needs. I met
with Paul at his initial consultation, then had a follow-up visit with full 

X-ray and CT scan to measure bone density and propose treatment
recommendations.

Paul had erosive tooth wear and was missing posterior teeth. He wanted 

his teeth to look better and told me he did not like his removable partial
denture.

As a Prosthodontist, I have experience planning multi-stage treatments and


can coordinate with a patient’s general dentist and other dental specialists.

The treatment plan I presented was to place implants in the edentulous areas
for tooth replacement and restore his teeth with zirconia restorations.

The treatment sequence for Paul included the following:

• Initial records including upper and lower models and 



a centric relation record.

• Full contour wax-up for


case presentation and
implant planning 

using implant planning
software.

• Testing of the chosen new


vertical dimension with
provisionalization.

• Full contour monolithic


zirconia restorations on
the maxillary arch.

Continued on
next page...

Do you have a patient in Paul’s situation? Or another complex case?


If you have a question about a case and want another opinion, give me a call. Or, if there’s a
case that you want to work together on, please fill out and send in the enclosed referral form.

My office and I will take great care of your patient and keep you informed. Dental professionals refer
to my office as The Complex Case Specialists™ because we perform complex cases every day.

Dr. Bill Scruggs, Prosthodontist ! Specialist in Complex Care ! 919-623-0294 (cell) ! DrBillScruggs@NCprosthodontics.com 2
FROM THE PROSTHO FILES

Continued from previous page…

The following considerations made this case challenging:

1. Having dental implants placed on an elderly patient with lack


of quality bone for support. 


2. Also, Paul wanted to avoid a sinus lift. He was interested in


implant therapy but was hesitant because of the location of
the right maxillary sinus in relation to where the distal implant
needed to be located to appropriately support the implant
bridge. But because the treatment team was able to use
implant planning software, we were able to angle the implant
enough to miss the sinus. This approach allowed an adequate
sized implant in native bone (4.3x13), while maintaining the
ability to restore the implant with adequate support for the
implant bridge.

At follow-up, Paul said he was thrilled with the restorations and


getting rid of his partial had been a life-changing experience.
Best of all, he said: “My wife loves them.”

I refer patients back to their general dentist for routine care, unless advised otherwise by the referring office,
depending on the patient and treatment. If you have comments or questions about how I treated Paul from this
example, please email me directly at: DrBillScruggs@NCprosthodontics.com

Before After

Have A Laugh: Denture-Inspired Phone Cover…

I hope I made you smile during your busy day!


I take the care of patients referred to my office
seriously, including knowing how to educate
them so they feel comfortable.
It’s my goal to help every patient understand
even the most difficult procedures, so they can
regain the function and esthetics they desire.

Dr. Bill Scruggs, Prosthodontist ! Specialist in Complex Care ! 919-623-0294 (cell) ! DrBillScruggs@NCprosthodontics.com 3
The Complex Case Specialists TM

ABOUT NC PROSTHODONTIC SPECIALISTS


Bill Scruggs, DDS, MS Paul Scruggs, DDS, PA Tony Molina, DDS, MS
Dr. Bill Scruggs earned Dr. Paul Scruggs had a Dr. Tony Molina
an AEGD degree along military career spanning served in the Air Force
with his Masters in 24 years, attaining the as Dental Laboratory &
Prosthodontics. He rank of Army Colonel. 
 Infection Control
shares his techniques He has also been a Officer, attaining the
and experience with professor teaching 
 rank of Colonel. He
colleagues at study part-time at UNC in is also a professor in
clubs, CE programs, the Prosthodontics the Prosthodontics
and dental symposiums. program for 30 years. program at UNC.

NC Prosthodontic Specialists is a comprehensive, specialty dental practice that focuses on the restoration and replacement 

of missing teeth with natural-looking, well-fitted, comfortable prosthetic teeth primarily using dentures, implants, and crowns.
The team at NC Prosthodontic Specialists have training and private practice experience that make treatments of complex cases
more successful, including the following examples:
• Patients with severely worn/damaged teeth, missing all teeth, or with ill-fitting dentures can receive a full arch of 

natural-looking teeth to restore function & esthetics. Each prosthesis is customized in the on-site dental laboratory.
• Patients with congenital defects, a chronic condition, or traumatic injury can receive oral prostheses, which may be 

a combination of dental implants, crowns, bridges, or veneers.
• Patients with difficult anterior cases in the esthetic zone can receive single or multiple dental implants to replace 

missing teeth — or veneers, crowns, or bridges may be used to improve the appearance of their smile.
Personal Message To Fellow Dental Practitioners: “As the referring dentist, you know your patient’s mouth and 

have key insight into your patient’s needs. We want to work with you to provide your patients with the best possible
treatment outcomes. We will treat your patient in a manner that will reflect well on you and strengthen your relationship
with your patient. We are here to make you look good! When your patient’s care is completed, they are referred back to
your office for their ongoing dental care. We are grateful for your colleagueship and trust with your patients!”

Why other dental professionals work with a Prosthodontist


Prosthodontists are specialists in implant, esthetic, and reconstructive dentistry.

1. You have a patient requiring complex treatment outside of your typical practice. 


Examples include patients with vertical dimension discrepancies, severely resorbed ridges, 

inadequate interarch space, TMJ, severe bruxism, traumatic tooth loss, or congenital abnormalities.

2. You have a patient with complex needs that may drain your time.


If your patient may require treatment from several specialists, Prosthodontists can help because 

they are trained to appropriately stage and manage complex treatment plans.

3. You have a demanding patient who wants perfect esthetics.



Examples include patients with a high smile line or needing a single tooth replacement in the 

esthetic zone. A Prosthodontist is trained in selecting the best solutions for high-demand patients.

4. You have a question and want to discuss a case with a colleague to ease your mind.


A Prosthodontist can be an excellent resource for you to ask questions because they are trained in 

many types of complicated treatments. For example, you may want to consult or refer to a Prosthodontist 

for complex implant-supported restorations. A Prosthodontist can work with you or complete the treatment 

for you to achieve the best in both function and esthetics.

Dr. Bill Scruggs, Prosthodontist ! Specialist in Complex Care ! 919-623-0294 (cell) ! DrBillScruggs@NCprosthodontics.com 4