Full Mouth Oral Rehabilitation
Presentation Category
Implant Dentistry
Introduction/Context/Diagnosis
This is a clinical case demonstrating the placement, design, and delivery of multiple dental implant and fixed restorations in a highly restored and edentulous mouth. A large maxillary edentulous span with supra-erupted mandibular incisors, generally does not have adequate restorative space for the final maxillary implant restoration. If ortho intrusion of the mandibular incisors is not valid, then dentine reduction can be performed to increase restorative space if radiographs show calcific metamorphosis. The clinical success and longevity of dental implants is based on the mechanical environment that they function in. Occlusal design is critical to the survival of a dentition highly restored with dental implants. The term “implant protected occlusion” focuses on an occlusal scheme to optimize the survival of dental implants
Methods/Treatment Plan
Implant occlusal design was completed based on the rules of “implant protected occlusion”. The reduction of the mandibular anterior teeth was split into two appointment in order to asses any post op sensitivity. Teeth were reduced by 0.75mm at each appointment for a total of 1.5mm in order to make sufficient room for the final maxillary restoration.
Results/Outcome
The occlusal design of “implant protected occlusion” was successfully completed. The patient reported no sensitivity and optimal bite in all functions. All teeth in lateral excursions were placed into group function in order to disperse the shear forces. The angle of inclination of the maxillary anterior teeth during protrusive was made as shallow as possible in order to lower shear forces. Overtime, porcelain can wear the opposing natural dentition and change the overall occlusal design. Regular recall exams must be made in order to constantly diagnose the occlusion and prevent occlusal interferences. The mandibular anterior teeth were successfully reduced, with no post op sensitivity, to allow space for the final maxillary restoration.
Significance/Conclusions
Traditionally, a rotational path RPD is used to restore a long span edentulous patient with supra-erupted mandibular incisors. However, through evidence based dentistry a higher standard of care can be given to address the patient’s highly esthetic chief concern.
Format
Event
Full Mouth Oral Rehabilitation
This is a clinical case demonstrating the placement, design, and delivery of multiple dental implant and fixed restorations in a highly restored and edentulous mouth. A large maxillary edentulous span with supra-erupted mandibular incisors, generally does not have adequate restorative space for the final maxillary implant restoration. If ortho intrusion of the mandibular incisors is not valid, then dentine reduction can be performed to increase restorative space if radiographs show calcific metamorphosis. The clinical success and longevity of dental implants is based on the mechanical environment that they function in. Occlusal design is critical to the survival of a dentition highly restored with dental implants. The term “implant protected occlusion” focuses on an occlusal scheme to optimize the survival of dental implants
