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Case presentation


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Case presentation

  1. 1. FULL MOUTH REHABILITATION Dr. Bahjat Abu Hamdan Consultant Prosthodontist CASE PRESENTATION 1
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  4. 4. INTRODUCTION  Patient arrived to the dental center seeking restoring the esthetic and the function of his mouth which is severely deteriorated by his bad history of careless behavior toward his oral hygiene.  He visited and consulted many dentist but he refused the treatment planning by insisting on replacing his missing teeth by FPD and crowning the deteriorated teeth. 4
  5. 5. EXAMINATION  Chief complain restoring the esthetic and the function  Patient fits well  46, 45 are missing teeth. 5
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  7. 7. Points taken in consideration.  Due to the dental attrition there will be eruption of the affected tooth with its alveolar bone.  The free way space ( due to the attrition ) could not be completely compensated by the eruption of the remaining teeth.  The free way space for CI is about 2-3 mm in the premolar area 3-5 mm for CII and 1 mm or less for CIII. 7
  8. 8. Points taken in consideration In CIII the dominated movement is open close so that lateral forces are minimal, also there is coincidence between the deep glenoid fossa and the mandibular movements. In class III there is coincidence between CO and occlusion in CR The neuro-muscular system is the least affected by the pathologic changes so its considered as reference after muscle relaxation. Evaluation of VD changes for at least three months and its reflexes on the NMS and TMJ. 8
  9. 9. Points taken in consideration.  Teeth with short clinical crowns due to attrition or caries should undergo crown lengthening to insure a ferrule of 2-3 mm in the sound tissue of the affected tooth.  If the damage attends 50% or more of the crown a post should be used in the build up of the crown.  When the caries index is high the use of retraction cord is mandatory when you take the final impression.  In case where the tooth crown is too short and there no enough space use the pulp chamber crown.  Mutual protection between the anterior and the posterior teeth. 9
  10. 10. Points taken in consideration.  In complicated cases temporary restoration should be done to reach a satisfactory esthetic and functional permanent restoration.  Ten years success rate is about 95% for an implant. A tooth with RCT + parapost with crown has 90% success for ten years.  The bio mechanic principles of FPD.  The strategic teeth.  Treatment of complicated cases is the result of cooperation between the different dental specialties.  Treatment planning. 10
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