How to plan a full mouth rehabilitation?
technique for full-mouth rehabilitation using a thermoformed tray to create direct composite restorations. This technique consists of creating a full-mouth rehabilitation wax-up, duplicating it in stone and then using a thermoforming device to create a guard that will be used to mold the direct restorations. This guard is
How are crowns made for a full mouth rehabilitation?
technique for full-mouth rehabilitation using a thermoformed tray to create direct composite restorations. This technique consists of creating a full-mouth rehabilitation wax-up, duplicating it in stone and then using a thermoforming device to create a guard that will be used to mold the direct restorations. This guard is
Is full-mouth rehabilitation of severely worn dentition possible?
Nov 14, 2012 · Then, the wax-up on the lower arch was completed (Figure 10). Finally, temporary stents and reduction guides could be made by the laboratory team for use during the preparation appointment. At the consultation appointment with the patient, the decision was made to complete the full-mouth restorative work in segments: the maxillary arch first ...
What are the benefits of composite augmentation for front teeth?
The diagnostic wax-up (Figure 16.28) allows the height and shape of the teeth to be predicted and to determine the increased occlusal vertical dimension that is required. Provisional restorations can then be made based on the wax-up, either in composite directly built up in the mouth or from provisional crowns.
What is a full mouth rehabilitation?
It might sound like a complicated procedure, but full mouth rehabilitation merely means combining restorative dental treatments to fix or rebuild your smile. Our goal is to not only help you enjoy smiling again, but also to strengthen and fortify your healthy oral tissues and tooth structures, as well.
How do I know if my composite restoration is high?
2:556:29Adjusting Occlusion After Restoration - YouTubeYouTubeStart of suggested clipEnd of suggested clipWe should see equal contacts on all the teeth. We should see that the contacts are on the workingMoreWe should see equal contacts on all the teeth. We should see that the contacts are on the working cuts on the central groom after that's done then we will check for lateral interferences.
How long does full mouth restoration last?
The entire process, from start to finish, takes up to six months or more. There are two surgeries and one or two other visits to complete this process.
How can I increase my Ovd?
Appliances causing extrusion of posterior teeth are useful in the increasing OVD in situations with lack of space for restorations. Appliances causing intrusion of the anterior teeth are useful in maintaining OVD and correcting deep bite in patients.
What happens if filling too high?
A high filling is a filling which is placed too high causing unnecessary contact between the filling and corresponding teeth. As the high filling continues to make contact with other teeth, it causes swelling and inflammation of the periodontal ligament.Sep 16, 2014
What does it feel like when a filling is too high?
One of the first signs of a high filling is experiencing pain when you bite down, this is due to your ligaments around the tooth starting to swell. You may feel sensitivity in the teeth the filling comes in contact with because it wears down the enamel, causing a cavity or even the nerve to become exposed.Oct 20, 2019
How long does it take for gums to heal after oral surgery?
About 3 days after your tooth extraction, your gums will begin to heal and close around the removal site. And finally, 7-10 days after your procedure, the opening left by your extracted tooth should be closed (or almost closed), and your gums should no longer be tender or swollen.
Do dentures shorten your life?
We know that your quality of life is impacted by your dentures. Better quality dentures can improve your life on a daily basis. But that's not all they could do: they could actually extend your life. That's according to a new study, which shows that wearing dentures could reduce your risk of death by nearly 20%!Jun 30, 2020
How many teeth will a dentist pull at once?
How many teeth can I have extracted at once? There is no limit to the number of teeth you can have extracted at once. While having multiple teeth extracted during the same procedure is rare, it is sometimes the only option for patients with severe tooth decay.Oct 25, 2021
How do you calculate loss of OVD?
Several techniques are used to assess OVD loss [47, 48], such as pre-treatment record, incisor height measurement, phonetic evaluation, patient relaxation, assessment of facial appearance, radiographic evaluation, neuromuscular evaluation [47], and deglutition, among others [48].
What determines Ovd?
The vertical dimension when the mandibular teeth are occluding with the maxillary teeth is defined as the occlusal vertical dimension (OVD). The OVD for dentate individuals is mainly determined by the remaining dentition, hence loss of tooth substance might influence the OVD.Feb 28, 2012
How long do infants have rampant dental caries?
31 Usually the children have been nursed for 2 or 3 years, spending long stretches at the breast. One infant had early signs at 9 months, and by 18 months she required full mouth reconstruction.
How long does it take to restore teeth after bleaching?
As with all adhesive restorations, if the patient is undergoing bleaching, a minimum of 2 to 3 weeks should pass before one proceeds to restoring the teeth. The timing of inlays and onlays versus other restorative services is determined on a case-by-case basis. Although patients are often eager to proceed with anterior esthetic improvements, they need to understand that restored stability in the posterior is critical to the durability and longevity of any cosmetic anterior service.
What is innovative element?
Innovative Elements. The ability to make a major change— whether it be a smile makeover for cosmetic purposes or a full-mouth rehabilitation for patients with severe breakdown—without prepping or with only very minor prepping is an important step forward.
What is a moment in physics?
Moments (Torques) Another essential concept is the idea of a moment or torque. A moment or torque is a loading action that tends to rotate a body. Most commonly, moments on a body such as an implant or a tooth are produced by the actions of forces.
Stabilize the occlusion first
I explain to the patient that the anterior teeth must be done first primarily due to function. The interaction of the anterior teeth are critical in speech and phonetics. In addition, the esthetics of the case are determined by the height of both the maxillary and mandibular anterior teeth.
What determines the border movements of the TMJ?
The border movements of the TMJ are determined by the anatomy of the TMJ itself. Specifically the condylar path is determined by the shape and form of the condyle/disc assembly and the muscle movements unique to each patient. One must work within the condylar path and that is not determined by the posterior teeth.
You need properly mounted models and diagnostic photos
To execute a full mouth rehab, the first two critical steps are accurate models mounted in centric relation and proper diagnostic photos. From the photos, using the Dawson Diagnostic Wizard, one can determine a very close approximation of the height and width of the maxillary anterior teeth.
Now we can place the temporaries
Once the anterior teeth are temporized and approved by the dentist and the patient, I will complete the lower anteriors first and cement while the upper temporaries are in place. Next, and often at the same visit, I will remove the upper temporaries, impress and send to the lab to cement the upper anteriors at the next visit.
I learned this lesson the hard way
I learned this lesson the hard way when, before attending the Dawson Academy, I restored the posterior teeth first only to see the anterior teeth were not even close to the proper position for function or esthetics. I was an part-time instructor at UK College of Dentistry at the time. I asked everyone in the Restorative department for help.
Medical and Dental History
Diagnosis, Risk Assessment, and Prognosis
- Periodontal: The examination revealed probing depths of 4 mm to 8 mm on the lingual surfaces of posterior teeth with areas of bleeding. Facial probing depths were primarily 2 mm to 3 mm, with a few 4-mm measurements and an isolated 5-mm pocket on the distobuccal of tooth No. 31. No gingival recession was noted. In fact, the patient’s free gingival margins were equal with or coro…
Treatment Goals
- The goals of treatment were as follows: Restore worn teeth and manage functional risk by establishing an MIP that was stable, with bilateral, simultaneous, equal intensity contacts.2Eliminate periodontal pockets, and position the gingiva in the proper position. Manage the risk of fracture for structurally compromised teeth by restoring with cohesively and adhesive…
Treatment Phases
- Periodontal Periodontal pocket reduction surgery was performed for all posterior teeth. This provided more favorable clinical crown heights for the necessary restorative treatment. Teeth Nos. 6 through 11 and 23 through 26 had esthetic crown-lengthening surgery to expose the entire anatomical crowns. Scaling and root planing was also performed during the periodontal surgery …
Conclusion
- This case illustrates a method to systematically diagnose, plan, and stage treatment to restore a patient’s worn dentition. The patient’s partial facial paralysis made esthetic evaluation more challenging. The patient’s repose position was the guiding determinant of anterior tooth length.11 The patient was extremely pleased with the final result and exhibited a full smile with considera…
Acknowledgments
- The author would like to thank and recognize Roberta Shaklee, DDS, MS for periodontal surgery; Tony Kardelis, DDS, MS for implant surgery; and Angelika Oeckl, owner of Subrisi Smile Technology for outstanding laboratory support.
References
- 1. Young DA, Kutsch VK, Whitehouse J. A clinician’s guide to CAMBRA: a simple approach. Compend Contin Educ Dent. 2009;30(2):92-98. 2. Kois JC, Phillips KM. Occlusal vertical dimension: alteration concerns. Compend Contin Educ Dent. 1997;18(12):1169-1177. 3. Kois JC. New challenges in treatment planning: incorporating the fundamentals of patient risk managem…