Full mouth rehabilitation aims to restore the form and function of the masticatory system to as close to normal as possible. It involves restoring multiple teeth that are missing, worn down, broken, or decayed. The document discusses various classifications of patients for full mouth rehabilitation based on the degree of wear and available space. It also covers the objectives of occlusal schemes, philosophies for full mouth rehabilitation including gnathological and Youdelis approaches, and considerations for treatment planning such as examination, diagnosis and dividing treatment into pre-prosthetic, prosthetic and maintenance phases.
One of the best seminar of the author. Covered in detail regarding the increasing vertical dimension, centric relation, methods to record centric relation, philosophies of occlusion and in detail everything about full mouth rehabilitation.
One of the best seminar of the author. Covered in detail regarding the increasing vertical dimension, centric relation, methods to record centric relation, philosophies of occlusion and in detail everything about full mouth rehabilitation.
Failures in Fixed Partial Denture
(Prosthodontics FPD- Dental science)
Various types of failures in the fabrication of fixed partial denture
Dr.Sachin Sunny Otta
St.Gregorios Dental College,Kothamangalam,Ernakulam
loading protocols in dental implants about indications and contraindications of conventional , immediate,progressive and delayed loading of dental implants
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The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
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Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
Failures in Fixed Partial Denture
(Prosthodontics FPD- Dental science)
Various types of failures in the fabrication of fixed partial denture
Dr.Sachin Sunny Otta
St.Gregorios Dental College,Kothamangalam,Ernakulam
loading protocols in dental implants about indications and contraindications of conventional , immediate,progressive and delayed loading of dental implants
Orientation jaw relation /certified fixed orthodontic courses by Indian denta...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
full mouth rehabilitation/dental crown &bridge course by Indian dental academyIndian dental academy
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
Twin block are simple bite blocks that effectively modify the occlusal inclined plane with the help of upper and lower bite blocks that engage occlusal inclined plane.
The main objective of Twin-block is to induce supplementary lengthening of the mandible by stimulating increased growth at the condylar cartilage.
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The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
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management of vertical maxillary excess /certified fixed orthodontic courses ...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
00919248678078
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
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The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Diagnosis and treatment planning in implants 2. /certified fixed orthodontic ...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Iimportance of keeping records in dental practice Asmita Sodhi
keeping thorough dental records is very important than you may think , it provide invaluable data to future students and practitioners , save you from litigation , share and spread education , unleash the power within....dental records
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
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Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
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Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
1. FULL MOUTH
REHABILITATION
Under The Guidance Of
Dr Akshey K Sharma
Dr Pardeep Bansal
Dr Poonam Bali
Dr Rajnish Bansal
Dr Gagandeep K Chahal
Dr Rajnanda Khuller
Presented by
Asmita sodhi
Pg student
2. CONTENTS
• Introduction
• Goals
• Indications
• Classification of patients
• Objectives of Occlusal schemes
• Philosophies for full mouth rehabilitation
• Treatment Philosophies
3. The goal of dentisty is increasing the sapan of
functioning just as the goal of medicine is to
increase the life span of the functioning
individual.
Planning and executing the restorative
rehabilitation of a decimated occlusion is
probably one of the most intellectually and
technically demanding tasks facing a restorative
dentist.
4. DEFINITION
ACCORDING TO GPT-9
Full mouth rehabilitation is defined as the
restoration of the form and function of the
masticatory apparatus to as nearly a normal
condition as possible
FULL MOUTH REHABILITATION
12. Contraindications for full mouth
rehabilitation
Malfunctioning mouths that do not need extensive
dentistry and have no joint symptoms should be
best left alone. Prescribing a full mouth
rehabilitation should not be taken as a preventive
measure unless there is a definite evidence of
tissue breakdown
In short, it can be concluded that :
No pathology- No treatment.
15. Classification by Turner and Missirlain
(1984)
• The patients were classified into three categories –
• Category 1 - Excessive wear with loss of vertical
dimension.
• Category 2 - Excessive wear without loss of vertical
dimension of occlusion but with space available.
• Category 3 - Excessive wear without loss of vertical
dimension of occlusion but with limited space available
16. Category 1 - Excessive wear with loss of vertical
dimension.
• A typical patient in this category has few posterior teeth
and unstable posterior occlusion. There is excessive wear
of anterior teeth.
• Closest speaking space of 3mm and interocclusal
distance of 6mm.
• there is some loss of facial contour that results in
drooping of the corners of mouth.
• Patients with dentinogenesis imperfecta with excessive
occlusal attrition, around 35 years of age and appearing
prognathic in centric occlusion also belongs to this
category.
17.
18. Category 2- Excessive wear without loss of
vertical dimension of occlusion but with space
available
• Patient has adequate posterior support and
history of gradual wear.
• Closest speaking space of 1mm and
interocclusal distance of 2-3mm.
• Continuous eruption has maintained
occlusal vertical dimension leaving
insufficient interocclusal space for
restorative material.
• History of bruxism
• Parafunctional oral habits
19. Category 3 –- Excessive wear without loss of
vertical dimension of occlusion but with limited
space available
• Posterior teeth exhibit minimal wear but anterior teeth
show excessive gradual wear
• Centric relation and centric occlusion are coincidental
with closest speaking space 1mm and interocclusal
distance 2-3mm.
• It is most difficult to treat because vertical space must
be obtained for restorative material.
• Vertical space obtained by
• Orthodontic movement
20. Classification by Brecker
Clinical Procedures In Occlusal
Rehabilitation Charles Brecker In 1966
• Group I
• Class I – Patients with collapse of vertical dimension of
occlusion because of shifting of existing teeth caused by
failure to replace missing teeth.
• Class II – Patients with collapse of vertical dimension of
occlusion because of loss of all posterior teeth in one or
both jaws with remaining teeth in unsatisfactory occlusal
relationship.
• Class III – Patients with collapse of vertical dimension of
occlusion because of excessive attritional wear of
occlusal surfaces.
21. • Group II
• Class I – Patients with all or sufficient natural teeth
present, with satisfactory occlusal relationship.
• Class II – Patients with limited teeth present but in
satisfactory occlusal relationship requiring aid in the
form of occlusal rims.
• Group III – Patients requiring maxillofacial surgery of
orthodontic treatment as an aid in restoring the lost
vertical dimension.
• Group IV – Patients in whom sectional treatment is
required over extended periods of time because of status
of health of the patient, age or economic factor.
22. OBJECTIVES OF OCCLUSAL
REHABILITATION
• Static centric occlusion in harmony with the
maxillomandibular relation.
• An even distribution of stress in centric
occlusion over the maximum number of
teeth.
• Lateral and anteroposterior freedom of
movement in C O.
FULL MOUTH REHABILITATION
23. OBJECTIVES…
• Masticatory efficency which involves uniform
contact and an even distribution of stress on
eccentric functional tooth inclines which are
coordinated with the incisal guidance and
normal fuctional condylar movements.
FULL MOUTH REHABILITATION
24. Objectives….
• Reduction Of The Buccolingual Width Of The
Occlusal Surfaces Of The Teeth, And A
Reduction Of The Balancing Incline Contacts As
A Means For Reducing A Traumatogenic Load
On The Structures Supporting The Dentition.
Full Mouth Rehabilitation
25. Constants
•Patients present in our practices with functional
determinants that are unchangeable by the restorative
dentist as part of their present condition.
•THESE CONSTANTS INCLUDE
1.INTERCONDYLAR DISTANCE,
2. HINGE AXIS POSITION
3.THE RELATIONSHIP OF THE MAXILLA TO THE
MANDIBLE IN CENTRIC RELATION
4. THE PATH OF THE CONDYLE-DISK ASSEMBLY IN
THE GLENOID FOSSAE.
• These constants must be evaluated, recorded, and
transferred to a patient simulation device accurately
enough to permit diagnostic planning prior to treatment
and the fabrication of dental restorations during
treatment.
26. OCCLUSAL SCHEMES
(AN OCCLUSAL SCHEME IS A PATTERN OF
OCCLUSAL CONTACT USED FOR
RECONSTRUCTION)
FULL MOUTH REHABILITATION
27. Gnathological Philosophy
(Stuart Ce1964)
• Centric Relation Contact Position (CRCP)and The
Intercuspal Position (ICP) (Centric
Occlusion).Are Coincident
• Canine Guided Lateral Excursions
• Posterior Disclusion In All Excursions.
• Lingual Concavity Of Anterior Teeth Is
Determined By Condylar Guidance
• Wax Up Done In Fully Adjustable Articulator.
• Good For Restoring Cases With Large Horizontal
Component Of Cr And Ip.
Full Mouth Rehabilitation
28.
29. In 1929 C.H. Schuyler stated that maximum
intercuspation must occur in the retruded
mandibular position (centric relation) under all
circumstances
Schuyler’s principles were
1. A static co-ordinated occlusal contact of the
maximum number of teeth when the mandible is in
centric relation.
2. An anterior guidance that is in harmony with
function in lateral eccentric position on the working
side.
3. Disclusion by the anterior guidance of all posterior
teeth in protrusion.
4. Disclusion of all non-working inclines in lateral
excursions.
5. Group function of the working side inclines in
lateral excursions.
30. In order to accomplish these goals, the following
sequence is advocated by the P.M.S. philosophy:
PART 1. Examination, diagnosis, treatment planning,
prognosis
PART 2. Harmonization of the anterior guidance for
best possible esthetics, function, and comfort
PART 3. Selection of an acceptable occlusal plane and
restoration of the lower posterior occlusion in harmony
with the anterior guidance in a manner that will not
interfere with condylar guidance.
PART 4. Restoration of the upper posterior occlusion
in harmony with the anterior guidance and condylar
guidance. The functionally generated path technique is
so closely allied with this part of the reconstruction that
it may almost be considered part of the concept.
31.
32. The advantages of the technique are many. Some of the major ones are as follows:
• It is possible to diagnose and plan treatment for the entire rehabilitation before
preparing a single tooth.
• It is a well-organized, logical procedure that progresses smoothly with less wear
and (car on the patient, operator, and technician.
• There is never a need for preparing or rebuilding more than eight teeth at a
time.
• It divides the rehabilitation into separate series of appointments. It is neither
necessary nor desirable to do the entire case at one time.
• There is no danger of "getting at sea" and losing the patient's present vertical
dimension. The operator knows exactly where he is at all times.
• The functionally generated path and centric relation are taken on the occlusal
surface of the teeth io be rebuilt at the exact vertical dimension to which the case
will be constructed.
• All posterior occlusal contours are programmed by and are in harmony with
both condylar border movements and a perfected anterior guidance.
• There is no need for time-consuming techniques and complicated equipment.
• Laboratory procedures are simple and controlled to an extremely fine- degree by
the dentist.
33. YOUDELIS
SCHLUGER S et al
• FOR ADVANCED PERIODONTAL CASES.
• CR AND IP ARE COINCIDENT.
• ANTERIOR DISCLUSION FOR
PROTRUSIVE AND CANINE DISCLUSION
FOR LATERAL EXCURSIONS.
FULL MOUTH REHABILITATION
34. Youdelis…
• Lateral Contacts Are Arranged Such That If
Canine Disclusion Is Lost Through Wear /Tooth
Movement-posterior Teeth Drop Into Group
Function.
• Both Fully /Semi Adjustable Articulators Can Be
Used.
Useful –Parafunction Cannot Be
Controlled/Canine Compromised Periodontally
Full Mouth Rehabilitation
35. Freedom In Centric
(Ramfjord Sp)
• Area Of Freedom B/W Cr And Ip-0.5mm.
• Either Canine Guidance/Group Function,but
Ant. Guidance Will Be Delayed During
Posterior Contact In Area Of Freedom.
• Cusp To Fossa Occlusion.
• Useful For Cases With Large Horizontal
Component Of Slide.
Full Mouth Rehabilitation
36. Nyman and Lindhe concept 1983
• Used in advanced periodontal disease.
• Clinically hypermobility of teeth, unfavourable
distribution of teeth.
• Bridge on such abutment teeth exhibit mobility
• But such bridge hypermobility can be tolrated, provided
it does not exhibit increase with time or interfare with
patients comfort or bridge function
• Such mobile bridge can further exagerrate the
periodontal weaking but can be prevented by designing
occlusion in such a way to obtain & maintain stability.
• Even and simultanuous contacts all over the dentition in
ICP and excursion.
37. • If distal abutment teeth are missing in a cross arch
bridge with increased mobility, balance and
functional stability obtained by cantilever units.
• However cantilevers increased risk of failure.
• If increased mobility is not observed, balancing
contacts on non working side should be removed.
• When bridge exhibit increased mobility- fulcrum
identified, occlusion designed so that forces exerted
by masticatory muscles meet the bridgework
simultaneously with balanced load on both side of
fulcrum
38.
39. Occlusal scheme RCP–ICP relationship Excursive contacts Comments
Gnathological (1964) Coincident, with tripod contacts Canine-guided lateral excursions,
posterior disclusion in all
excursions. Anterior and
posterior contacts are mutually
protected1
Good for restoring cases without
a large horizontal component of
RCP–ICP slide. Real purists
would insist on the use of a fully
adjustable articulator and all that
goes with it.
Youdelis (1977) Coincident, with tripod contacts As for gnathological, but
designed to drop into group
function if canines wear or move
Useful option where excursive
parafunction cannot be
controlled or where the canine is
compromised
Pankey–Mann–Schuyler (1963) Area of freedom2 between ICP
and RCP (<0.5 mm) and
morphology functionally
generated
Anterior guidance determined
functionally on temporaries.
Either canine guided or group
function
The potential for error with the
functionally generated path
technique, which is used to
determine the occlusal
morphology of posterior teeth is
considerable
Area of freedom in centric (1982)Area of freedom between ICP and
RCP (0.5 mm ± 0.3 mm); cusp to
fossa occlusion
Either canine guided or group
function, but anterior guidance
will be delayed during posterior
contact in area of freedom
Useful where there has been a
large horizontal component in
the RCP–ICP slide before
treatment. Area of freedom needs
careful adjustment
Balanced occlusion (1960) Area of freedom between ICP and
RCP
Balanced working and non-
working contacts in lateral
excursions. Balanced anterior
and posterior contacts in
occlusion
Keeps complete dentures stable
during excursions, but difficult to
manage in the natural dentition
and risk of non-working-side
overloading
Nyman and Lindhe (1983) RCP and ICP must have even
contact
Bilaterally balanced excursive
contacts determined in
provisional (long-term
temporary) restorations and then
copied into definitive restorations
This is used in cross arch bridges
where there is advanced, but
controlled, periodontal disease.
Balanced contacts give stability to
an otherwise mobile bridge
40. HOBO TWIN STAGE CONCEPT
(Hobo St)
(Theory Of Disclusion)
• Two Stage Procedure:
• Occlusal Morphology Of Posterior Teeth
Reproduced Without Ant. Segment.
• Ant. Morphology Reproduced With
Ant.Segment And Ant. GUIDANCE-
PRODUCE Std AMT OF DISCLUSION.
FULL MOUTH REHABILITATION
41. HOBO’S TWIN TABLE PHILOSOPHY
Another philosophy was given by Dr. Sumiya
Hobo
which is followed in rehabilitation of dentate
patients. He proposed Twin table concept which
developed anterior guidance to create a
predetermined, harmonious disclusion with the
condylar path.
42. •The technique utilizes 2 different customized
incisal guide tables. The first incisal table is termed
INCISAL TABLE WITHOUT DISCLUSION. It is
fabricated by preparing die systems with removable
anterior and posterior segments
• It is fabricated by preparing die systems with
removable anterior and posterior segments. This table
helps us achieve uniform contacts in the posterior
restorations during eccentric movements
• used to fabricate restorations for posterior teeth
44. The other incisal table is made when the
articulator can simulate border movements
by placing 3 mm plastic separators behind the
condylar elements. This is termed THE INCISAL
GUIDANCE WITH DISCLUSION.
• used to achieve incisal guidance with disclusion.
51. Restoring all upper posterior teeth only
1. Preliminary
mouth
preparation
2. Selective grinding
3. Prepare all upper
posterior
4. Correctness of
anterior guidance
should be verified
and modify
5. If canine guided-
set condylar path
at 20degrees
complete wax up
6. Or complete the
restoration on
fully adjustable
articulator out of
excursion
7. For group
function- use FGP
8. Place posterior
restorations and
do necessary
modifications
52. Restoring all upper but no lower
teeth
1. Preliminary mouth
preparation
2. Selective grinding of
lowers
3. Prepare upper
posterior
4. Correct anterior
guidance
5. Do “alternate tooth
preparation” in
anteriors
6. Centric record,
articulate lower cast
with first upper cast
7. Customize guide
table
8. Articulate final cast
9. Duplicate anterior
restorations by using
throw- away patterns
10. Replace upper
posteriors as
described
11. Reevaluate disclusion
and guidance and do
necessary corrections
in patients mouth
53. Restoring all posterior but no anterior
Preliminary mouth preparation
Broadrick occlusal plane analysis
Prepare lower teeth accordingly
Harmonize anterior guidance
Complete lower wax patterns and restorations
Place lower restorations
Prepare upper posteriors
Complete upper posterior restorations
Remove balancing contacts
Redefine working contacts
54. Restoring all lower teeth but no upper
teeth
1. Preliminary mouth preparation
2. Redefine interferences in the
upper arch
a. correct marginal ridges
b. equilibrate occlusion
c. harmonious anterior guidance
4. Every other lower anterior
tooth should be prepared,
through away patterns
5. CR record with ant. teeth in
contact
6. Remaining teeth should be
prepared
7. Articulate working cast
8. Place through away patterns
9. By using this guide prepare
lower ant restorations
10. Prepare and place posterior
restorations
11. Remove balancing contacts
12. Redefine working contacts
55. Preparing all upper teeth and lower
posterior teeth only
1. Priliminary mouth
preparation
2. Restablish anterior
guidance
3. Prepare every other
maxillary ant tooth
4. Place through away wax
pattern
5. Prepare all anterior
teeth
6. Establish
predetermined anterior
guidance
7. Prepare mandibular
posteriors
8. By using brodrick
occlusal plane analyser
establish occlusal plane
9. complete lower
restorations
10. Prepare maxillary
posteriors
11. Establish desired
occlusion
12. Place all restorations
13. Redefine balancing and
working side contacts
56. PREPARING ALL UPPER AND LOWER TEETH
1. Preliminary mouth preparation
2. Prepare lower anterior teeth
3. If the anterior relation is acceptable,
prepare the lower wax patterns against
unprepared maxillary ant
4. If unacceptable relation, reestablish the
anterior guidance
5. Place provisional restorations in the
redefined anterior guidance
6. Complete the lower restorations by
exactly duplicating the incisal edge
position of provisional restorations
7. Place lower restorations against upper
provisionals to verify the ant guidance
57. 8. Prepare and restore upper anterior teeth (exactly
duplicate the pattern of provisionals)
9. Place upper anterior restorations
10. Refine the anterior guidance.
11. Prepare lower posterior teeth by taking guidance of
Broadrick occlusal plane analyzer
12. Reestablish the occlusal plane.
13. Complete lower posterior restorations
14. Complete upper posterior restorations accordingly
15. Refine centric, working and nonworking contacts
58. Treatment techniques
Simultaneous restoration of both arches
(Bailey, Grubb, Linkow)
Advantages Disadvantages
Freedom in creating esthetic
occlusal plane
Arduous, unpredictable,
patient visits
Freedom in occlusal scheme Full arch anaesthesia
Freedom in intra-arch tooth
spacing and inter-arch
crown position
Increased chair time, full
arch temporaries required
Maximum freedom in
creating and controlling
porcelain esthetics
Multiple occlusal records,
highly accurate cross arch
impressions
59. Individual quadrants (Pankey,
Mann, Dawson, Granger)
Advantages Disadvantages
Reduced chair time Restriction for achieving
ideal occlusion when
altering occlusal plane
Sequential provisional
restorations
Less freedom in controlling
porcelain aesthetics
Quadrant anaesthesia
Vertical Dimension is
controlled
Impression procedures are
easier
60. Segmented simultaneous arch
technique (Binkly & Binkly)
• Combines desired features of bothe the
techniques
• Simplifies essential basic procedures for
reconstruction
61. Freedom to produce occlusal
scheme
. .
Freedom in tooth spacing and
intra arch crown position
. .
Freedom for porcelain work . .
Teeth preparation quadrant
wise
. .
Chair side temporaries . .
Easier final impression . .
Control of VDO . .
Anesthesia by quadrant . .
Control of appointment length . .
62. References
Okeson J P:Management of temperomandibular joint
Sumiya Hobo : Twin – tables technique for occlusal
rehabilitation : part 1 – Mechanism of anterior guidance j
prosthet dent 1991, vol 66 pg 299-303.
Sumiya Hobo : Twin – tables technique for occlusal
rehabilitation : part 11 –Clinical procedures
j prosthet dent 1991, vol 66 pg 471-477
Philosophies in full mouth rehabilitation – a systematic review
Int J Dent Case Reports 2013; 3(3): 30-39
Occlusion for fixed prosthodontics:A historical perspective of the
gnathological influence J Prosthet Dent 2008;99:299-313