By William Robbins, DDS, MA
With the increased emphasis on interdisciplinary treatment in recent years, the deficiencies associated with traditional methods of diagnosis and treatment planning have become more evident and problematic. Many years ago when I was in dental school, I learned to gather a lot of information about the patient and then sit down and make a treatment plan. Dentistry was much simpler in those days. In a complex patient, the treatment plan was primarily dictated by information provided by study casts which were mounted on a sophisticated articulator in centric relation. At that time in history, the primary tools available for treating the complex restorative patient were functional crown lengthening surgery and increasing the vertical dimension of occlusion. The treatment plan was simply based on restorative space, anterior tooth coupling and resistance and retention form of the final preparations, with no focus on placing the teeth in the correct position in the face. Practitioners did not have access to advanced periodontal, orthodontic, orthognathic surgery and plastic surgery tools that are currently available. With the advent and common usage of these new treatment modalities, the historical method of diagnosis and treatment planning is no longer adequately serving our profession. This style of treatment planning is only effective when prescribing single tooth dentistry. When the case becomes more complex, the old style of treatment planning doesn’t tell the dentist where the teeth and supporting structures fit into the patient’s face.
Global Diagnosis is a treatment planning strategy that guides the dentist through the process of diagnosing and sequencing an interdisciplinary treatment plan. It provides a systematic approach to diagnosis and treatment planning the complex interdisciplinary dental patient with a common language that may be used by the orthodontist, periodontist, and oral and maxillofacial surgeon, as well as the restorative dentist.
Dr. Robbins maintains a full-time private practice and is Clinical Professor in the Department of Comprehensive Dentistry at the University of Texas Health Science Center at San Antonio Dental School. He graduated from the University of Tennessee Dental School in 1973. He completed a rotating internship at the Veterans Administration Hospital in Leavenworth, Kansas and a 2-year General Practice Residency at the V.A. Hospital in San Diego, California. Dr. Robbins has published over 80 articles, abstracts, and chapters on a wide range of dental subjects. He coauthored a textbook, Fundamentals of Operative Dentistry – A Contemporary Approach. He is a diplomat of the Federal Services Board of General Dentistry and the American Board of General Dentistry. He is past president of the American Board of General Dentistry, the Academy of Operative Dentistry, the Southwest Academy of Restorative Dentistry, and is currently president of the American Academy of Restorative Dentistry.