• Title/Summary/Keyword: Full-mouth rehabilitation

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Integrating 3D facial scanning in a digital workflow to CAD/CAM design and fabricate complete dentures for immediate total mouth rehabilitation

  • Hassan, Bassam;Greven, Marcus;Wismeijer, Daniel
    • The Journal of Advanced Prosthodontics
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    • v.9 no.5
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    • pp.381-386
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    • 2017
  • PURPOSE. To integrate extra-oral facial scanning information with CAD/CAM complete dentures to immediately rehabilitate terminal dentition. MATERIALS AND METHODS. Ten patients with terminal dentition scheduled for total extraction and immediate denture placement were recruited for this study. The patients were submitted to a facial scanning procedure using the in-office PritiMirror scanner with bite registration records in-situ. Definitive stone cast models and bite records were subsequently submitted to a lab scanning procedure using the lab scanner (iSeries DWOS; Dental Wings). The scanned models were used to create a virtual teeth setup of a complete denture. Using the intra-oral bite records as a reference, the virtual setup was incorporated in the facial scan thereby facilitating a virtual clinical evaluation (teeth try-in) phase. After applying necessary adjustments, the virtual setup was submitted to a CAM procedure where a 5-axis industrial milling machine (M7 CNC; Darton AG General) was used to fabricate a full-milled PMMA immediate provisional prosthesis. RESULTS. Total extractions were performed, the dentures were immediately inserted, and subjective clinical fit was evaluated. The immediate provisional prostheses were inserted and clinical fit, occlusion/articulation, and esthetics were subjectively assessed; the results were deemed satisfactory. All provisional prostheses remained three months in function with no notable technical complications. CONCLUSION. Ten patients with terminal dentition were treated using a complete digital approach to fabricate complete dentures using CAD/CAM technology. The proposed technique has the potential to accelerate the rehabilitation procedure starting from immediate denture to final implant-supported prosthesis leading to more predictable functional and aesthetics outcomes.

Full mouth rehabilitation of the intellectually disabled patient with collapsed bite using partial removable dental prosthesis: a case report (교합이 붕괴된 지적장애 환자의 국소의치 수복증례)

  • Kim, Min-Ji;Yang, Hong-So;Park, Sang-Won;Lim, Hyun-Pil;Yun, Kwi-dug;Park, Chan
    • Journal of Dental Rehabilitation and Applied Science
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    • v.33 no.3
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    • pp.216-222
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    • 2017
  • Intellectual disability is an imperfect disorder in which mental development is permanently retarded and development of intellectual ability is inadequate. Having intellectual disabilities makes it difficult to handle their own work and adapt to social life. For this reason, it is difficult to hygienically manage the patient's oral condition, multiple caries are easily observed, and the periodontal disease incidence rate is high. The patient in this case is a 33-year-old female with a mental retardation first grade who had a problem with meals. In first visit, Patients had decreased occlusal vertical dimension and posterior bite collapse due to periodontitis and multiple caries. This case reports a satisfactory functional and esthetic results by reconstructing occlusion using partial removable dental prosthesis.

The effectiveness of a pre-procedural mouthrinse in reducing bacteria on radiographic phosphor plates

  • Hunter, Allison;Kalathingal, Sajitha;Shrout, Michael;Plummer, Kevin;Looney, Stephen
    • Imaging Science in Dentistry
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    • v.44 no.2
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    • pp.149-154
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    • 2014
  • Purpose: This study assessed the effectiveness of three antimicrobial mouthrinses in reducing microbial growth on photostimulable phosphor (PSP) plates. Materials and Methods: Prior to performing a full-mouth radiographic survey (FMX), subjects were asked to rinse with one of the three test rinses ($Listerine^{(R)}$, $Decapinol^{(R)}$, or chlorhexidine oral rinse 0.12%) or to refrain from rinsing. Four PSP plates were sampled from each FMX through collection into sterile containers upon exiting the scanner. Flame-sterilized forceps were used to transfer the PSP plates onto blood agar plates (5% sheep blood agar). The blood agar plates were incubated at $37^{\circ}C$ for up to 72 h. An environmental control blood agar plate was incubated with each batch. Additionally, for control, 25 gas-sterilized PSP plates were plated onto blood agar and analyzed. Results: The mean number of bacterial colonies per plate was the lowest in the chlorhexidine group, followed by the Decapinol, Listerine, and the no rinse negative control groups. Only the chlorhexidine and Listerine groups were significantly different (p=0.005). No growth was observed for the 25 gas-sterilized control plates or the environmental control blood agar plates. Conclusion: The mean number of bacterial colonies was the lowest in the chlorhexidine group, followed by the Decapinol, Listerine, and the no rinse groups. Nonetheless, a statistically significant difference was found only in the case of Listerine. Additional research is needed to test whether a higher concentration (0.2%) or longer exposure period (two consecutive 30 s rinse periods) would be helpful in reducing PSP plate contamination further with chlorhexidine.

Oral rehabilitation of a young adult with amelogenesis imperfect using metal-ceramic restoration: a clinical report (금속 도재 수복물을 이용한 청년기 법랑질 이형성증 환자의 수복증례)

  • Kim, Hong-Jun;Lee, Jae-Hoon;Han, Dong-Hoo;Moon, Hong-Suk
    • The Journal of Korean Academy of Prosthodontics
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    • v.50 no.3
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    • pp.210-215
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    • 2012
  • Some patients with generalized attrition and teeth discoloration may want their anterior teeth to be treated just for esthetic improvement. Ameologenesis imperfecta, however, should be considered for such patients prior to any treatment with thorough clinical and radiographic examination. If a patient is diagnosed with amelogenesis imperfecta, the treatment on anterior teeth just for esthetic purpose is not advisable. In this case, a young man with amelogenesis imperfecta was treated with metal-ceramic restorations. The patient had generalized attrition, teeth discoloration, crown fracture, and cross-bite on the left teeth. The ultimate objective of this treatment was to enhance esthetics and masticatory function. The cross-bite on the left anterior teeth was treated with restorations, whereas the reverse horizontal overlap was maintained on the posterior. The patient was satisfied with the result esthetically and functionally, and the third month recall examination revealed no pathologic changes associated with the treatment.

Treatment of Severely Worn Dentition: A Clinical Report (심하게 마모된 치열의 보철수복)

  • Choi, Mee-ra
    • Journal of Dental Rehabilitation and Applied Science
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    • v.25 no.4
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    • pp.337-347
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    • 2009
  • The treatment of a patient with severely worn dentition is often challenging due to loss of vertical dimension and an uneven occlusal plane. To establish a correct occlusal plane and space for prostheses, it is necessary to increase vertical dimension. Occlusal vertical dimension is the vertical position of mandible to maxilla in centric occlusion. McAndrew reported that in spite of the change of the vertical dimension, the altered occlusion would be maintained if the equal occlusal contacts were established in centric relation. Centric relation is defined as an anatomically and physiologically stable, repeatable posture of the mandible and can be considered a most acceptable treatment and reference position. In this case we tried to treat patients with severely worn dentition by the use of centric relation and increased vertical dimension for the space of prostheses.

Full-mouth rehabilitation of skeletal anterior open bite with severely decayed dentition: A case report (심한 우식을 동반한 골격성 전치부 개방 교합 환자의 전악 수복 증례)

  • Kim, Seong-A;Noh, Kwantae;Pae, Ahran;Woo, Yi-Hyung
    • The Journal of Korean Academy of Prosthodontics
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    • v.55 no.1
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    • pp.79-87
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    • 2017
  • The open bite malocclusion is a common clinical entity and has multifactorial causes. Development of effective treatment plan and management is dependent on proper diagnosis. The skeletal open bite patient requires a coordinated orthodontic and orthognathic surgical approach to achieve stable occlusion, acceptable esthetics, and improved function. But in case of open bite with severely decayed dentition, restoration in the entire dentition is necessary. Using the facial analysis and diagnostic wax-up, the most effective treatment was prosthetic rehabilitation. The provisional restorations were fabricated to satisfy esthetic and functional requirements, which result in the uniformly distributed occlusal force, anterior and canine guidance. The inter-arch relationship, labio-dental harmony, and the soft tissue aspect, which is important to estimate the longevity were evaluated. Definitive restorations of monolithic zirconia were made by replicating provisional restorations by using the latest CAD/CAM technology. They were delivered to the patient and clinical follow-up observation was satisfactory.

Prosthetic treatment with correcting edentulous maxillomandibular relation (무치악치조제의 개선을 통한 보철치료)

  • Rhee, Ye-Kyu;Huh, Yoon-Hyuck;Park, Chan-Jin;Cho, Lee-Ra
    • Journal of Dental Rehabilitation and Applied Science
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    • v.30 no.4
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    • pp.339-349
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    • 2014
  • If the maxillomandibular relationship is unstable or requires treatment for improved function and esthetics, the first treatment objective is to provide stable occlusal contacts. The patient has moderate mental retardation. Due to inadequate vertical overjet, horizontal arch malrelation and excessive tooth loss, full mouth rehabilitation was required. The purpose of treatment planning is to establish physiologic maxillomandibular relation. Using cephalometrics for occlusal analysis is an aid to make a decision. The amount of horizontal bone reduction was calculated with evaluating soft tissue profile. After provisional denture placement, healing of the surgical site and newly adapted arch relationship was evaluated. The patient satisfied with esthetics and showed stable holding contacts. Periodic examination is needed to exclude occlusal disharmony.

Full mouth rehabilitation of the patient with crossed occlusion using removable partial denture restoration: A case report (엇갈린 교합 환자에서의 가철성 보철을 이용한 전악구강회복 증례)

  • Choi, Yu-Ra;Kang, Jeong-Kyung;Kim, Na-Hong;Chang, Hee-Won
    • The Journal of Korean Academy of Prosthodontics
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    • v.55 no.1
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    • pp.38-45
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    • 2017
  • In removable partial denture with crossed occlusion, it is difficult to meet the satisfaction of patient due to variable movement of denture and unfavorable stability under loading. In a case with few unilaterally teeth remaining, additional treatments such as implantation or residual root are required to assure bilaterally stable support. However, due to the medical condition of the patient with hypertension, angina and old age etc., removable partial denture was planned as treatment in this case. Proper diagnosis, accurate analysis and full understanding of the adaptation for neuromuscular system are necessary to recover the vertical dimension of patient from a decreased vertical dimension due to crossed occlusion.

Implant-supported fixed prosthesis restoration of fully edentulous patient using computer-guided implant surgery and immediate loading: A case report (Computer guided implant surgery와 immediate loading을 활용한 무치악 환자의 전악 임플란트 고정성 보철물 수복 증례)

  • Hyeon-Me Sung;Kyoung-Hee Sul;Sun-Woo Kang;Jung-Han Kim
    • The Journal of Korean Academy of Prosthodontics
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    • v.62 no.2
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    • pp.131-139
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    • 2024
  • In a edentulous patient, various methods can be employed for prosthetic treatment using implants, such as implant-supported fixed prostheses, overdentures, hybrid prostheses, and implant assisted removable partial denture. In this case, in a patient with moderate to severe chronic periodontitis requiring full arch extractions, implants were strategically placed using computer-guided surgery. In the maxilla, due to inadequate bone quality and quantity leading to insufficient initial stability, delayed loading was implemented, and interim prosthesis was used during the osseointegration period. In the mandible, stable initial stability was achieved, allowing for immediate loading to reduce patient discomfort. Primary stability is considered the most crucial factor for obtaining immediate loading, so a thorough clinical and radiological evaluation of the remaining alveolar bone quantity and quality must be conducted before surgery.

Full-mouth rehabilitation using digital method to transfer provisional restoration to final fixed implant restoration (디지털 방법을 활용하여 임시수복물을 최종 고정성 임플란트 수복물로 이행한 완전 구강 회복 증례)

  • Cho, Eunhan;Lee, Younghoo;Hong, Seoung-Jin;Paek, Janghyun;Pae, Ahran;Kim, Hyeong-Seob;Kwon, Kung-Rock;Noh, Kwantae
    • The Journal of Korean Academy of Prosthodontics
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    • v.60 no.4
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    • pp.362-373
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    • 2022
  • For a full-mouth fixed prosthetic treatment of the edentulous patient, it is essential to confirm the proper tooth position and thorough evaluation of the remaining alveolar bone and soft tissue before surgery. CAD-CAM dentistry and guided implant surgery have such advantages of providing simultaneous planning of surgery and prosthetic treatment to ensure pre-knowledge of the treatment. In this clinical case, using the digital technology, digital temporary denture fabrication, esthetic evaluation before fixed prostheses treatment, and guided surgery planning was possible. After the surgery, previously obtained data was used for fabricating fixed temporary prostheses. Definitive zirconia prostheses transferred from the provisional prostheses were fabricated and functionally and esthetically satisfying results were obtained.