Full mouth rehabilitation of the patient with severely worn dentition: a case report

The severe wear of anterior teeth facilitates the loss of anterior guidance, which protects the posterior teeth from wear during excursive movement. The collapse of posterior teeth also results in the loss of normal occlusal plane and the reduction of the vertical dimension. This case report describes 77-year-old female, who had the loss of anterior guidance, the severe wear of dentition, and the reduction of the vertical dimension. Occlusal overlay splint was used after the decision of increasing vertical dimension by anatomical landmark, facial and physiologic measurement. Once the compatibility of the new vertical dimension had been confirmed, interim fixed restoration and the permanent reconstruction was initiated. This case reports that a satisfactory clinical result was achieved by restoring the vertical dimension with an improvement in esthetics and function.     

牙列缺损伴重度磨耗的咬合重建序列治疗体会

目的：评价牙列缺损伴重度磨耗的咬合重建序列治疗的效果。方法：选取牙列缺损伴重度磨耗患者36例,采用固定-活动联合修复方法实施咬合重建,通过3年随访,观察临床修复效果。结果：咬合重建后36例患者取得较满意疗效。结论：有序、合理的咬合重建治疗可以恢复患者正常的咀嚼功能,缓解颞下颌关节紊乱病及牙齿敏感,改善美观。     

Spontaneous mandibular fracture in a partially edentulous patient: case report

This article describes the case of a 78-year-old patient whose mandibular fracture was treated with miniplate osteosynthesis. After initial treatment, panoramic radiography revealed a fracture of the miniplate, and at follow-up, a loosening of the replacement plate. For the dental practitioner, this clinical case highlights the importance of panoramic radiography and occlusal analysis and stabilization for diagnosis of mandibular fracture, evaluation of miniplate fracture and treatment, especially in the absence of trauma.     

Prosthodontic management of worn dentition in pediatric patient with complete overlay dentures: a case report

Overlay complete dentures are simple, reversible and economical treatment modality for patients with congenital or acquired disorders that severely affect the tooth development. It satisfies both the esthetic and functional demands where the extraction of teeth is not generally indicated. In pediatric patients, the overlay dentures establish a relatively stable occlusion that improves patient''s tolerance to the future treatment procedures for worn dentition. This clinical report highlights the imperative need of appropriate treatment strategy and application of maxillary and mandibular overlay dentures in a pediatric patient who suffered from congenitally mutilated and worn dentition.     

Treatment of the worn dentition: 2

This is the second of two articles concerning the practical techniques involved in reconstruction of the worn dentition. Part 1 discussed approaches to managing occlusion, and practical techniques for restoring worn anterior teeth. This second article will describe the procedures involved when both anterior and posterior teeth are worn, and then give a guide to the management of the short clinical crown.     

牙列缺损治疗计划一例

本文比较了可摘局部义齿、双套冠义齿和种植义齿三种牙列缺损修复方案的优缺点。并通过介绍一例短牙弓合并间断缺牙病例．对其修复方案的选择、治疗原则、治疗步骤及最终修复效果进行讨论。     

Full mouth rehabilitation of partially and fully edentulous patient with crown lengthening procedure: a case report

BACKGROUND

In order to restore severely attrited teeth properly, surgical intervention in the form of a crown-lengthening procedure may be required. And also, proper diagnosis and treatment sequencing is critical to obtain a successful results. Adequate diagnostic wax-up ensures good esthetics and healthy periodontal tissue.

CASE DESCRIPTION

This clinical case report describes a diagnostically based protocol for restoration on mandibular anterior teeth with crown lengthening procedure and the treatment of partially edentulous mandible combined with an edentulous maxilla. In addition, the effort to prevent the combination syndrome was described.

CLINICAL IMPLICATION

An interdisciplinary diagnosis and examination through visualization of the desired results ensure conservative and more predictable outcome.     

Treatment of the worn dentition. 1

This is the first of two articles concerning the practical techniques involved in reconstruction of the worn dentition. The authors describe some of the procedures available and assess the appropriateness of 'conformative' versus 'reorganized' approaches to the occlusion. They continue by describing some practical aspects of reconstructive work. Part 2 will look at other practical techniques.     

Full-mouth rehabilitation of a patient with severely worn dentition and uneven occlusal plane: a clinical report

Severe tooth wear is frequently multifactorial and variable. Successful management is a subject of interest in dentistry. A critical aspect is to determine the occlusal vertical dimension (OVD) and a systematic approach that can lead to a predictable and favorable treatment prognosis. Management of patients with worn dentition is complex and difficult. Accurate clinical and radiographic examinations, a diagnostic wax-up, and determining OVD are crucial. Using mini-implants as orthodontic anchorage may facilitate orthodontic movement of teeth to improve their position, which is necessary for favorable prosthetic treatment. A 46-year-old man was referred for restoration of his worn and missing teeth. After diagnostic work-up, provisional removable prostheses were fabricated for both jaws, evaluated clinically, and adjusted according to esthetic, phonetic, and vertical dimension criteria. Clinical crown lengthening and free gingival graft procedures were performed in appropriate areas. Drifting of the left posterior mandibular teeth was corrected using mini-implants as orthodontic anchorage. Two conventional implants were inserted in the right mandibular edentulous area. After endodontic therapy of worn teeth, custom-cast gold dowels and cores were fabricated, and provisional removable prostheses were replaced with fixed provisional restorations. Metal-ceramic restorations were fabricated, and a removable partial denture with attachments was fabricated for maxillary edentulous areas. An occlusal splint was used to protect the restorations. Full-mouth rehabilitation of the patient with severely worn dentition and an uneven occlusal plane was found to be successful after 3 years of follow-up. This result can encourage clinicians to seek accurate diagnosis and treatment planning to treat such patients.     

Mobility of premolars under load in partially edentulous dentition

The mobility of the upper and lower premolars under load was investigated in relation to the interproximal contact and occlusal facets. The mobility was measured on ten subjects with the molars missing in the bucco-lingual and mesio-distal direction, using a non-contact sensor system, when a 500 gram load was applied in the horizontal direction, during hard biting in intercuspation and biting of foods. The ratio of the tooth movement in the bucco-lingual direction to the mesio-distal direction was larger in the upper premolars than in the lower ones. As the total mobility increased, the tooth movement was larger on the buccal side than on the lingual side of the upper jaw, on the lingual side than on the buccal side of the lower jaw, and on the mesial side than on the distal side of both jaws. The direction of the movement did not coincide with the direction of the load, due to the horizontal rotation. When biting, the first premolars showed a mesial movement and the second premolars showed a more distal movement than the first premolars. A correlation between the direction of the tooth movement during hard biting and that of the facets was observed.     

Treatment of edentulous and partially edentulous patients with CAD/CAM frameworks: a pilot case study.

Computer-assisted design/computer-assisted manufacturing (CAD/CAM) has been used successfully in commercial industry for several decades and is only now becoming more common for use within the clinical setting. This presentation will outline how CAD/CAM frameworks present numerous advantages over conventional castings when used to treat edentulous and partially edentulous patients in such areas as strength, biocompatibility, and precision machining. Recent advancements in CAD/CAM technology have decreased the costs associated with the fabrication of implant- and tooth-borne frameworks.     

Rehabilitation of the worn dentition

The purpose of this review was to evaluate the literature on the rehabilitation of tooth wear, with some pertinent historical, epidemiological and aetiological aspects of tooth wear provided as background information. In historical skull material, extensive tooth wear, assumed to be the result of coarser diets, was found even in relatively young individuals. Such wear is seldom seen in current populations. Although many of the factors associated with extensive tooth wear in historical material are no longer present or prevalent, new risk factors have emerged. In the young individual, the literature points to a global rise in soft drink consumption as the most significant factor in the development of tooth wear through dental erosion. Among older individuals, lifestyle changes and chronic diseases that are controlled with medications that may, in turn, result in regurgitation and/or dry mouth, are possible reasons amongst others for the widespread clinical impression of an increasing prevalence of tooth wear. The aetiology of tooth wear is multifactorial and the role of bruxism is not known. Clinical controlled trials of restorative and prosthodontic approaches for the range of clinical conditions that wear can give rise to, are limited in number and quality. Equally, the striking lack of evidence regarding the long-term outcomes of treatment methods and materials calls for caution in clinical decision-making. Notwithstanding these observations, clinicians have provided and continue to provide rehabilitative strategies for managing their patients' worn dentitions that range traditionally from extensive prosthodontics to an increasing reliance on adhesive techniques.     

Treatment of an edentulous patient with surgically induced microstomia: a clinical report

This clinical report describes the fabrication of a sectioned mandibular complete denture for a patient with severe microstomia. Dovetails were created in the denture base to orient and secure the prosthesis.