Maxillary and mandibular overlay removable partial dentures for the restoration of worn teeth

Reclaiming the Smile: Full Mouth Rehabilitation of a Generalized Attrition Patient Using the Hobo Twin-Stage Technique

This clinical report details the successful rehabilitation of a 63-year-old male patient with severe tooth wear, a reduced vertical dimension of occlusion, and esthetic concerns. The Hobo twin-stage procedure addressed these issues while improving the patient's oral health and quality of life. After ensuring adequate oral hygiene, the treatment began with scaling and root planning, followed by diagnostic impressions. An occlusal splint was fabricated, followed by a diagnostic wax-up and tooth preparation. Full-arch impressions of prepared teeth were made using the addition of silicon elastomeric impression material, and chairside provisional crowns were fabricated. The working casts were mounted on a semi-adjustable articulator, and the metal copings were tried on before being built up in porcelain. The patient achieved successful outcomes and expressed satisfaction with the treatment. The Hobo twin-stage technique and porcelain-fused-to-metal crowns can be viable approaches for restoring the teeth's form and function while enhancing the patient's oral health and esthetics. However, regular follow-up appointments and good oral hygiene maintenance are essential for the long-term success of the treatment.

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.

Assessment of Periodontal and Hygiene Conditions of Removable Partial Dentures in Individuals With Clefts

OBJECTIVE

To assess hygiene conditions in removable partial dentures (RPDs) and to compare the periodontal status between abutment and nonabutment teeth in clefts patients.

DESIGN

Cross-sectional.

SETTINGS

Tertiary referral hospital.

PARTICIPANTS

Forty-five patients of both genders, aged 20 to 75 years, who were upper RPD wearers for at least 2 years, with cleft lip, alveolus, and/or palate who attended follow-up appointments between 2010 and 2012.

INTERVENTIONS

The clinical periodontal parameters assessed on abutment teeth (experimental group) and nonabutment teeth (control group) were probing depth, clinical attachment level (CAL), plaque index, and gingival index (GI). The RPDs were evaluated under the following parameters: hygiene conditions and type of clasp on abutment. Both groups were analyzed using Mann-Whitney, Kruskal-Wallis, and Dunn's statistical test. Statistical significance was set at P < .05.

RESULTS

One hundred sixty-six abutment teeth and 168 nonabutment teeth were evaluated in 45 patients. A statistically significant difference was found between the groups for the CAL parameter (P = .03). With regard to the prostheses' hygiene conditions through the Tarbet index parameter, of the 186 quadrants evaluated, 143 scored 2 and 3. Ackers' clasps were the most frequent clasps (n = 111). A statistically significant difference was found for the GI parameter (P = .03).

CONCLUSIONS

It was possible to conclude, in this cross-sectional study, that in general terms, the use of RPDs did not interfere in the periodontal conditions of abutment teeth; however, most prostheses presented poor hygiene and high quantity of dental plaque.

Restoration of the Occlusal Vertical Dimension with an Overlay Removable Partial Denture: A Clinical Report

The process of tooth loss throughout life associated with severe occlusal wear may pose a challenge in the rehabilitation of partially edentulous arches. In these cases, many therapeutic procedures are necessary because each tooth must be restored to obtain the correct anatomical contour and recover the occlusal vertical dimension (OVD). A removable partial denture (RPD) with occlusal/incisal coverage, also known as an overlay RPD, is an alternative treatment option with fewer interventions, and, consequently, lower cost. This clinical report reviews the principles involved in the clinical indication for an overlay RPD, as well as the necessary planning and execution, to discuss the feasibility and clinical effectiveness of this treatment, identifying the indications, advantages, and disadvantages of this procedure through the presentation of a clinical case. The overlay RPD can be an alternative treatment for special situations involving partially edentulous arches in patients who need reestablishment of the OVD and/or realignment of the occlusal plane, and it can be used as a temporary or definitive treatment. The main advantages of this type of treatment are its simplicity, reversibility, and relatively low cost; however, further studies are needed to ensure the efficacy of this treatment option.

Posterior open occlusion management by registration of overlay removable partial denture: A clinical report

This clinical report describes prosthetic rehabilitation of posterior open bite relationship in a patient with several missing teeth and skeletal Class III malocclusion. Primary diagnostic esthetic evaluations were performed by mounting casts in centric relation and estimating lost vertical dimension of occlusion. Exclusive treatments were designated by applying overlay removable partial denture with external attachment systems for higher retentions.

Implant-Supported Prosthetic Rehabilitation of a Patient with Localized Severe Attrition: A Clinical Report

Patients usually adapt to their existing occlusal vertical dimension (OVD). It is essential to resolve each of the problems associated with decreased vertical dimension as a result of attrition. This report describes the multidisciplinary dental treatment of a 40-year-old male patient who had severe tooth wear, resulting in reduced vertical dimension. After clinical evaluations, extraoral examination showed a reduction of the lower facial height, drooping, and overclosed commissures. Ten dental implants were placed into the maxillary and mandibular alveolar processes. During the osseointegration period, an interim removable partial denture was made at increased OVD to use in the first stage of rehabilitation. It was used for 3 months as a guide for preparing the definitive restorations. The patient's adaptation to the increased OVD was evaluated. During this period, he was asymptomatic. Following the evaluation period, the provisional fixed restoration was used for 3 months. Then, full-mouth definitive prostheses supported by a combination of implants and teeth were fabricated to upper and lower jaws. Osseointegration of the implants, peri-implant mucosa health, prosthesis function, and esthetics were assessed after 1 week and 1, 3, and 6 months. After 3 years of follow-up, no functional or esthetic difficulties with the implants and restorations were noted.

Full mouth rehabilitation of a patient with reduced vertical dimension using multiple metal ce ramic restorations

Rehabilitation of a patient with severely worn dentition after restoring the vertical dimension is a complex procedure and assessment of the vertical dimension is an important aspect in these cases. This clinical report describes the full mouth rehabilitation of a patient who was clinically monitored to evaluate the adaptation to a removable occlusal splint to restore vertical dimension for a period 1 month and provisional restorations to determine esthetic and functional outcome for a period of 3 months. It is necessary to recognizing that form follows function and that anterior teeth play a vital role in the maintenance of oral health. Confirmation of tolerance to changes in the vertical dimension of occlusion (VDO) is of paramount importance. Articulated study casts and a diagnostic wax-up can provide important information for the evaluation of treatment options. Alteration of the VDO should be conservative and should not be changed without careful consideration.

Reestablishment of occlusion through overlay removable partial dentures: a case report

Loss of posterior teeth may cause an imbalance in the stomatognathic system. Overlay removable partial dentures (ORPD) are a reversible and relatively inexpensive treatment for patients with severely worn teeth. This paper presents a treatment with ORPD in a 55-year-old male patient who had severe attrition in the maxillary and mandibular teeth, temporomandibular joint pain and reduced vertical dimension of occlusion (VDO). The treatment consisted in the reestablishment of the VDO using Lucia's jig, fabricating removable partial denture with reconstruction of the worn teeth without preparation. This therapy can be used as an alternative treatment to provide esthetic, function and stable occlusion in patients with severely worn teeth.

An appraisal on increasing the occlusal vertical dimension in full occlusal rehabilitation and its outcome

Increasing the occlusal vertical dimension for gaining sufficient restoration space in the management of severely worn dentition is being practiced. This contentious belief has lead to challenging thoughts regarding its effects on the Odonto-stomatognathic system. There are basic uncertainties and existing erroneous thoughts regarding the perception of increasing the occlusal vertical dimension. This manuscript will review the bite raising concepts and its outcome on the stomatognathic system.

Tooth wear and wear investigations in dentistry

Tooth wear has been recognised as a major problem in dentistry. Epidemiological studies have reported an increasing prevalence of tooth wear and general dental practitioners see a greater number of patients seeking treatment with worn dentition. Although the dental literature contains numerous publications related to management and rehabilitation of tooth wear of varying aetiologies, our understanding of the aetiology and pathogenesis of tooth wear is still limited. The wear behaviour of dental biomaterials has also been extensively researched to improve our understanding of the underlying mechanisms and for the development of restorative materials with good wear resistance. The complex nature of tooth wear indicates challenges for conducting in vitro and in vivo wear investigations and a clear correlation between in vitro and in vivo data has not been established. The objective was to critically review the peer reviewed English-language literature pertaining to prevalence and aetiology of tooth wear and wear investigations in dentistry identified through a Medline search engine combined with hand-searching of the relevant literature, covering the period between 1960 and 2011.

Full mouth rehabilitation of the patient with severely worn dentition: a case report

The severe wear of anterior teeth facilitates the loss of anterior guidance, which protects the posterior teeth from wear during excursive movement. The collapse of posterior teeth also results in the loss of normal occlusal plane and the reduction of the vertical dimension. This case report describes 77-year-old female, who had the loss of anterior guidance, the severe wear of dentition, and the reduction of the vertical dimension. Occlusal overlay splint was used after the decision of increasing vertical dimension by anatomical landmark, facial and physiologic measurement. Once the compatibility of the new vertical dimension had been confirmed, interim fixed restoration and the permanent reconstruction was initiated. This case reports that a satisfactory clinical result was achieved by restoring the vertical dimension with an improvement in esthetics and function.

Dental Erosion

There is some evidence that dental erosion is steadily spreading. To diagnose erosion, dental professionals have to rely on clinical appearance, as there is no device available to detect it. Adequate preventive measures can only be initiated if the different risk factors and potential interactions between them are known. When substance loss, caused by erosive tooth wear, reaches a certain degree, oral rehabilitation becomes necessary. Prior to the most recent decade, the severely eroded dentition could only be rehabilitated by the provision of extensive crown and bridgework or removable dentures. As a result of the improvements in composite restorative materials and in adhesive techniques, it has become possible to rehabilitate eroded dentitions in a less invasive manner.