From: Gary L Henkel DDS MAGD
To: ROOTS
Sent: Tuesday, August 17, 2010 2:40 AM
Subject: RE: [roots] opinions on appropriate management

I pray this photo compressed.  I’m using 2010 and they changed the usual place to compress for email.
Here’s a photo that will help.  I have no qualms at all about using invisalign to move these teeth.
Note how protrusive he is, so the space will close a great deal simply by retracting anterior.
But, big but, Gary is not doing butkus with this case until I get through to this guy that:

1. He has perio involvement everywhere, with calculus hanging all over the place.
   was referred to me specifically for invisalign, claims he had his teeth cleaned
   two months ago.  We never ever want to move teeth in the presence of perio, or we can
   move them into the trash can.

2. As Fred has pointed out, we have endo and a root tip to remove on #9
   (oops, let me translate that into Canadian speak , the one one! J )

3. Soft tissue sculpting with the laser between the 11 and the 21 (think I just spoke in Toronto
   over the weekend.  I’ve got this stuff down!)

4. A detailed plan for prosthetic reconstruction after the ortho.  He has multiple missing teeth.
   He has been advised simply moving the teeth to prove we can do so is not what needs to happen.
   Moving with a purpose towards a reconstructive end is what we need.

So I have another consult scheduled to review our findings.
He thinks he is dentally in good shape.  Wrong! - gary

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