J Korean Acad Prosthodont.  2018 Jan;56(1):70-76. 10.4047/jkap.2018.56.1.70.

Full mouth rehabilitation of severely worn dentition with implants and removable partial dentures

• Lee SE
• Lee WS
• Lee CW
• Lee SY

• KMID: 2402990
• DOI: http://doi.org/10.4047/jkap.2018.56.1.70

Abstract

Excessive tooth wear can lead to decrease in occlusal vertical dimension and can cause pathological changes in the oral environment and masticatory system. When recovering occlusal vertical dimension and occlusion, accurate diagnosis and analysis are essential. This clinical case describes a 75-year-old woman with severely worn dentition due to loss of the posterior support. Full mouth rehabilitation with occlusal vertical dimension increment was planned. Clinical and radiographic examinations, occlusal vertical dimension evaluation, and diagnostic wax-up were performed and patient adaptability was evaluated using provisional restorations. As for definitive restoration, considering economic condition of the patient, removable partial denture was fabricated and solitary implants were placed in the mandibular left and right posterior region to increase support and retention of the removable partial denture. During one year of follow-up, functional and esthetic outcomes were observed satisfactory.

Keyword

Mouth rehabilitation; Tooth wear; Occlusal vertical dimension; Dental implants; Removable partial denture

MeSH Terms

Aged
Dental Implants
Dentition*
Denture, Partial, Removable*
Diagnosis
Female
Follow-Up Studies
Humans
Mouth Rehabilitation*
Mouth*
Stomatognathic System
Tooth Wear
Vertical Dimension
Dental Implants

Figure

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  Fig. 1 Intraoral view of the patient before treatment. Severely worn mandibular natural teeth occluding maxillary PFM prosthesis were observed. (A) Maxillary occlusal view, (B) Frontal view, (C) Mandibular occlusal view.

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  Fig. 2 Initial panoramic radiograph before treatment. Wears on occlusal surface of the mandibular teeth and severe secondary caries with peri-apical lesions on the maxillary posterior teeth were observed.

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  Fig. 3 Diagnostic wax up at increased OVD. (A) Maxillary occlusal view, (B) Frontal view, (C) Mandibular occlusal view.

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  Fig. 4 Provisional restoration. (A) Maxillary occlusal view, (B) Frontal view, (C) Mandibular occlusal view.

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  Fig. 5 Cone beam computed tomography image for implant placement. (A) Mandibular right second molar, (B) Mandibular left second molar.

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  Fig. 6 Computer-aided design for porcelain fused metal framework fabrication using laser sintering technique. (A) Full contour design, (B) Cut-back.

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  Fig. 7 Definitive prostheses. (A) Maxillary occlusal view, (B) Frontal view, (C) Mandibular occlusal view, (D) Panoramic radiograph.

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