Full Mouth Rehabilitation Determined by Anterior Tooth Position

Clinical factors to consider in definitive treatment planning for patients with tooth wear

Diagnosis, disease control and prevention are the precursors to successful definitive restorative treatment of pathological tooth wear. This case series illustrates how proposed key clinical features can influence treatment complexity and provide the clinician with a logical sequence of treatment options for definitive management of tooth wear.

Contemporary full-mouth rehabilitation using a digital smile design in combination with conventional and computer-aided design/manufacturing restorative materials in a patient with bruxism: A case report

RATIONALE

Full-mouth rehabilitation of patients with bruxism and severely worn dentition poses a great challenge to clinicians. Several treatment planning methods and restorative materials are used to treat tooth wear in modern dentistry. Clinicians should be able to select the most suitable treatment planning methods and materials for individual patients depending on their specific situation.

PATIENT CONCERNS

A 47-year-old male was referred for evaluation of a severely worn dentition.

DIAGNOSES

Clinical and radiographic evaluation revealed tooth wear in the entire dentition. The interocclusal distance at rest was 4 mm, and the patient had a parafunctional habit of bruxism.

INTERVENTIONS

A digital smile design was used to formulate a treatment plan. Full-mouth rehabilitation was performed using a combination of conventional and digital materials and methods.

OUTCOMES

The full-mouth restoration showed satisfactory functions and esthetics. No complications were observed in the restorations, supporting tissues, and temporomandibular joints during 2-year follow-up.

LESSONS

In clinical practice, it is important to determine the optimal combination of the available methods for treatment planning. This case report details the formulation of a unique treatment plan for the dental rehabilitation of a severely worn out dentition, which is considered challenging due to the limitations imposed by biological tissues and restorative materials. The use of conventional and digital tools for treatment planning, patient education, and treatment execution was demonstrated.

Predictable prosthetic space maintenance during staged complete-mouth rehabilitation

Staged complete-mouth rehabilitation to accommodate a patient's financial constraints during the course of treatment is presented. Clear acrylic resin added to the anterior cameo surface of the maxillary fixed complete denture (FCD) served as a space maintainer. The restoration of the maxillary FCD addressed the patient's chief complaint. By adding the space maintainer, supraeruption of mandibular anterior teeth and encroachment of the prosthetic space, which could have resulted in additional treatment, was avoided. During the second stage of the complete-mouth rehabilitation, zirconia restorations were used to restore the mandibular arch to the maxillary FCD after straightforward removal of the space maintainer. This allowed a smooth transition after a delay in treatment without having to modify the previous treatment.