Rehabilitation of a Patient With Maxillary Defect and Severe Attrition Using Obturator Prostheses: A Case Report

Surgery for palate lesions may result in oro-nasal/antral communication, which reduces a person's quality of life by affecting swallowing, speech, and food reflux. The shape and size of this obturator prosthesis might vary based on the severity of the defect. This case report describes the prosthetic rehabilitation of the patient with post-COVID mucormycosis and generalized attrition of teeth using an obturator and full mouth rehabilitation.

Evaluation of Clinical Success, Caries Recurrence, and Oral Health-Related Quality of Life of Children Undergoing Full Mouth Rehabilitation for Early Childhood Caries: A Prospective Cohort Study

AIM

This prospective cohort study aimed to assess the clinical success, caries recurrence, and oral health-related quality of life of children undergoing full mouth rehabilitation for early childhood caries under general anesthesia. The study sought to understand the long-term impact of these interventions on early childhood caries (ECC) management.

METHODOLOGY

The study included 300 children aged three to six years diagnosed with ECC requiring full mouth rehabilitation under general anesthesia. The assessment included clinical success of various dental treatments, caries recurrence rates, and oral health-related quality of life using the Early Child Oral Health Impact Scale at baseline, 12 months, and 24 months post-treatment. Specialized caries preventive protocols were implemented, including education on oral hygiene, reminders, and nutritional guidance.

RESULTS

272 children attended the 12-month follow-up, out of which 11 children had new carious lesions. Two hundred fifty-two children were reported for the 24-month follow-up, in which 19 children reported new carious lesions. The clinical success rate of treatment was found to be high. The oral health-related quality of life showed a significant and sustained improvement from baseline to 12 months and further improvement at 24 months post-treatment.

CONCLUSION

Full mouth rehabilitation under general anesthesia is an effective approach for managing ECC in young children, with high clinical success rates and significant improvements in the oral health-related quality of life over two years. Preventive oral health strategies are necessary to maintain these positive outcomes and improve the overall well-being of affected children.

Managing the transition to a complex full mouth rehabilitation utilizing injectable composite

OBJECTIVE

This article describes the use of flowable injectable composite resins to facilitate transitional treatment of a complex complete mouth rehabilitation.

CLINICAL CONSIDERATIONS

Some patients require urgent and complex complete mouth rehabilitations that are time and cost intensive. Financial considerations can prevent some patients from pursuing treatment. This can result in the oral conditions worsening over time and compromising the long-term prognosis of the teeth.

CONCLUSIONS

Injectable composite resins can be used as a transitional bonding material for complex cases using an injection molding technique utilizing clear indices obtained from a diagnostic waxing. This allows for a full mouth rehabilitation to be performed in a single appointment, producing instant results.

CLINICAL SIGNIFICANCE

Transitioning with injectable composite as demonstrated in this case will immediately stabilize an otherwise deteriorating situation in a cost-effective way and allows patients to address the realities of financial or time constraints when transitioning to more durable porcelain restorations over a period of years.

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.

3D-Printed Overlay Template for Diagnosis and Planning Complete Arch Implant Prostheses

Dental implants are a reliable alternative to treating edentulism. In clinical situations where the dentition has been severely affected by partial edentulism, advanced wear, or periodontal disease, establishing important occlusal elements such as the occlusal plane, incisal guidance, and esthetics can be hard to visualize at the diagnostic stage. Contemporary data-acquisition technologies such as 3D scanners and CAD/CAM systems permit the precise manufacture of highly complex devices applicable to any stage of restorative treatment. The present clinical report presents an alternative technique for evaluating the projected artificial tooth relationships, vertical dimension, and occlusal plane in patients with severely weakened dentition by using a 3D-printed overlay template.

Method Presentation of a New Integrated Orthodontic-Conservative Approach for Minimally Invasive Full Mouth Rehabilitation: Speed Up Therapy

The materials available today allow for extensive oral rehabilitations in a non-invasive way, and often an orthodontic preparation is useful and, thanks to the use of clear aligners, is predictable and comfortable. A preliminary study of the wax-up, mock-up, and set-up allow the clinician to plan every aspect of the treatment in detail. Furthermore, the procedure offers the patient an intuitive and understandable view of the expected final result. The new proposed method, called “speed up therapy”, allows for the integration of the orthodontic set-up with the mock-up technique, simulating the occlusal and aesthetic components of the planned restoration, in all details. The clinical case presented, demonstrates step by step the predictability and clinical reliability of the proposed procedure. The final clinical result coincides exactly with the initial mock-up and demonstrates that the proposed method is predictable and reliable. The correct execution of the technique is rigorously customized, and its success is operator dependent, both for the clinical aspects and for the dental laboratory. Thus, the visualization of the objectives of the treatment constitutes a decisive support for the clinician and provides the patient with the possibility of benefiting from an immediate improvement by making it easier for them to accept a treatment plan. The visualization also includes an orthodontic phase that potentially lengthens the treatment but makes the realization more conservative and predictable.

Digitally Fabricated Dentures for Full Mouth Rehabilitation with Zirconia, Polyetheretherketone and Selective Laser Melted Ti-6Al-4V Material

CAD/CAM technologies have been embedded into the fabrication of removable partial denture (RPD). Various materials such as zirconia and polyetheretherketone (PEEK) are developed for subtractive manufacturing. As for additive manufacturing, dental professionals have begun to use selective laser melting (SLM) techniques for fabricating metallic RPD frameworks. This report demonstrates a case rehabilitated with a maxillary telescopic crown-retained combining PEEK and zirconia material denture and a mandibular Kennedy Class I RPD fabricated with SLM techniques. First, a conventional impression was performed and the master cast was mounted with a centric relation record. Digital models were obtained using tabletop scanners and then the telescopic primary zirconia crowns were designed and milled. After transferring the intraoral distribution of primary crowns using pick-up impression, secondary PEEK crowns and framework were designed, milled, and veneered with composite resin. Mandibular framework was designed and constructed using SLM technique with Ti-6Al-4V. Definitive prostheses for both jaws were finished and delivered. Delivered prostheses functioned well for a one-year period. The was patient satisfied with the improvements in chewing function and esthetics. Both substrative and additive manufacturing techniques are suitable for framework fabrication. Further investigation is needed for improving the mechanical performance and long-term prognosis of digitally made prostheses.

Rehabilitation of a deep bite patient with worn dentition using minimally invasive approach: A 3-year follow-up

Full mouth rehabilitation of severely worn teeth represents a challenging situation for dental clinicians. This case report describes the minimally invasive interdisciplinary approach for treatment of severely worn dentition with a loss of vertical dimension of occlusion. After 3 years of follow-up, no complication was observed.

Facts and Fallacies About Occlusal Philosophies for Full Mouth Rehabilitation

This article reviews various full mouth rehabilitation occlusal concepts along with their main beliefs and controversies. Many of those occlusal teachings were well-meant at the time they were introduced. However, closer examination reveals that many of them involved serious destruction of sound tooth tissue - without delivering many of their purported benefits.The biologic and structural disadvantages of 'subtractive' dental procedures, which were, and still are, undertaken to provide traditional full mouth rehabilitation are discussed. Those approaches are contrasted with the proven advantages of minimally destructive additive techniques, which can solve frequently encountered clinical problems previously deemed to require traditional 'full mouth rehabilitations'. Pragmatic clinical cases are used to illustrate how to solve common clinical problems by using minimally destructive means, without causing structural damage to residual sound tooth tissue.

Changes in Occlusal Philosophies for Full Mouth Rehabilitation

This article reviews some of the main tenets of different occlusal philosophies involved in 'full mouth rehabilitation' and evolved since the late 19^th century. This review is not intended as a comprehensive historical review of all the people who wrote, researched, or taught on the topic, and it is certainly not intended to disparage their well-meaning contributions. It is intended to highlight some of the changes that occurred in relation to full mouth rehabilitation occlusal concepts along with the dates when they were articulated.

Halitosis in Children Undergoing Full Mouth Rehabilitation under General Anesthesia

Interventions and management modalities of pediatric halitosis have been suggested in the literature, however, the effect of full mouth rehabilitation (FMR) under general anesthesia (GA) on pediatric halitosis was not reported. Therefore, the present study was conducted to investigate parents' perceptions of their child's halitosis before and after FMR under GA; and to evaluate the effect of FMR on clinical halitosis. Fifty-seven children between 3-8 years old, scheduled for FMR under GA, were included after satisfying the inclusion criteria and upon parental consent. Parents' perception of halitosis in their children was evaluated using a standardized questionnaire and a breath sample was collected to assess the level of volatile sulfur compounds (VSCs) using OralChroma^TM before and after FMR under GA. Sixty percent (n = 34) of the parents perceived halitosis in their children before FMR and about 80% (n = 27) of them reported improvement in halitosis after FMR. Clinical halitosis was detected in 84.2% (n = 48) of the sample before treatment. A statistically significant reduction in halitosis was found in 56.3% (n = 27) of the children after treatment (p < 0.001). In conclusion, majority of parents perceived an absence or reduction of halitosis in their children following FMR and significant improvement of clinical halitosis.

A patient presentation: Planning and executing a difficult case in a full digital workflow

OBJECTIVE

In patients requiring extensive tooth replacement, including a change of VDO and/or a new orientation of the occlusal plane, a fully digital workflow still tends to be considered too much complex to be planned and performed. This clinical report describes a full mouth rehabilitation performed with a full digital approach.

CLINICAL CONSIDERATIONS

In a 50-year-old man with several missing teeth in the upper and lower arch, extensive decay on multiple teeth, severe attrition of the anterior teeth, treatment of the upper and lower arches was performed with dental implants, crowns and veneers. All prosthodontic therapy was realized with full monolithic ceramic materials (zirconia and lithium disilicate). The combination of digital information and monolithic materials enabled the clinician, the dental laboratory technician and the patient, to communicate effectively during treatment planning and to use the combination of digital workflow and monolithic materials to simplify the steps of treatment of a difficult case.

CONCLUSIONS

The combination of full digital workflow with full monolithic restorations in a full mouth rehabilitation allows a simplification of every clinical and lab step in a typically complex treatment.

Integrated Digital and Conventional Treatment Workflow in Guided Complete Mouth Implant Rehabilitation: A Clinical Case Report

Clinical Implications

The integration of both conventional and digital techniques in the treatment workflow can have a synergistic effect that facilitates the treatment of complex complete mouth prosthetic rehabilitations.

Abstract

The introduction of digital dentistry and CAD/CAM technology has redefined treatment concepts in implant dentistry—computer guided implant placement has become routine practice, and CAD/CAM prostheses are now commonplace. These advances in treatment options and modalities has led to a paradigm shift in the workflow of surgical and restorative treatments. This case report presents a customized staged treatment protocol that involves the strategic retention of teeth to serve as transitional abutments, which will support a computer guided implant surgical guide as well as a fixed interim prosthesis. The treatment protocol also describes an integrated digital and conventional workflow for full mouth implant-supported fixed prosthetic rehabilitations to provide improved patient care with more predictable outcomes and fewer complications.

Implant Survival between Endo-osseous Dental Implants in Immediate Loading, Delayed Loading, and Basal Immediate Loading Dental Implants a 3-Year Follow-up

Introduction:

With introduction of the term “ossteointegration of dental implant” by Branemark, advancement in implantology from 1957 to 2017 has come a long way with modification in implant type and in loading time. This study aims to evaluate the survival of endo-osseous immediate loading (IL) implant and basal IL implants in atrophic jaws with objective to compare implant survival in atrophic jaws for full mouth rehabilitation between endo-osseous IL versus endo-osseous delayed loading (DL) versus basal IL during 3-year follow-up.

Materials and Methods:

Fifty-two (34 endo-osseous and 18 basal) implants were placed in 4 patients requiring full mouth rehabilitation in atrophic jaws. Case 1: Endo-osseous DL implants in upper and lower arch, Case 2: Endo-osseous IL implants in upper and lower arch, Case 3: Basal IL implant in upper and lower arch, and Case 4: Endo-osseous DL in upper arch and basal IL implant in the lower arch. Intraoperative evaluation was done on the basis of pain (visual analog scale [VAS]), operative time, and initial primary implant stability. Postoperative evaluation was done on pain (VAS), infection, radiographically successful implant (orthopantomogram), and patient satisfaction (Grade 0–10).

Results:

All cases showed satisfactory results but more amount of intra- and post-operative pain was felt with immediate basal implants.

Conclusion:

We believe that clinicians should comply with patient requests, and for this reason, we agree with some authors to use minimally invasive techniques and to avoid when possible esthetic or functional problems associated with the use of removable prosthesis after teeth extractions.

Influence of full mouth rehabilitation on oral health-related quality of life among disabled children

The efficacy of full mouth rehabilitation (FMR) on oral health-related quality of life of physically disabled children was assessed. This prospective study was performed at Dental Department of Sultan Bin Abdulaziz Humanitarian City, Riyadh, and King Abdulaziz University Hospital, Jeddah, Saudi Arabia, during May 2012 to September 2014. A total of 186 physically disabled children aged 11-14 years were assigned to a test group (n = 97) or a control group (n = 89). FMR was applied for test group children at baseline and 3 months' visits, whereas those in the control group did not receive FMR. Both group children received dental kits and oral hygiene instructions. Children were asked to complete the Child Perceptions Questionnaire, whereas Parental-Caregiver Perceptions Questionnaire and Family Distress Domain questionnaire were completed by the parents/caregivers at baseline and 6 months' visits. Children in both groups showed positive trends in oral symptoms at 6 months compared with those at baseline. However, when they were compared to control, significant improvement in oral symptoms was observed in the test group at 6 months' visit (p < .05). Also when they were compared to control, significant improvements were observed in the functional limitation, emotional, and social well-being subscales of the Child Perceptions Questionnaire and on the Parental-Caregiver Perceptions Questionnaire scales at the end of the study (p < .05). Compared to the parents/caregivers of the control children, the parents/caregivers of the test-group children reported insignificant but positive trends in Family Distress Domain at the end of the study (p < .05). FMR in children reduced oral-related problems subsequently to a better oral health-related quality of life.

Full mouth rehabilitation of a patient with amelogenesis imperfecta: a case report

Amelogenesis imperfecta (AI) is a hereditary disorder expressing a group of conditions which cause developmental alterations in the structure of enamel. This disorder has an adverse impact on oral health and also hampers the quality of life of the individual causing physiologic problems. The treatment of such patients would not only upgrade their quality-of-life, but also improve their self-esteem. The correction of such severely worn out dentition may require extensive restorative treatment to achieve appropriate results. It is important to identify the factors that contribute to the excessive wear and loss of vertical dimension. The correction of the defects has to be done without violating the biologic or mechanical principles. Full mouth rehabilitation in such patients improves esthetics, function and comfort. The following case report presents a systematic approach in rehabilitating a case of AI hypoplastic type using full mouth metal reinforced porcelain restorations.

Interdisciplinary Full Mouth Rehabilitation of a Patient with Amelogenesis Imperfecta: A Case Report with 8 Years Follow-up

This case report deals with the interdisciplinary approach of a 28-year-old lady with Amelogenesis imperfecta of the hypoplastic kind. The patient came with a chief illness of worn out teeth, unsatisfactory esthetics and severe sensitivity of teeth. Her family history revealed a related situation in her father's brother and her sister. On clinical assessment, the crowns of all teeth were worn out. The plan of the treatment was to protect as much tooth structure, restore the vertical dimension, and improve esthetics and masticatory function. The treatment procedures involved prosthodontic, endodontic, and periodontic interventions. After recording the vertical height, endodontic treatment and crown lengthening were performed with respect to the lower anteriors. The lost vertical height was regained in stages by insertion of full coverage crowns for all the teeth. The patient's esthetic and functional needs were met with systematic and sequential interdisciplinary treatment approach.

Rehabilitation strategies for partially edentulous-prosthodontic principles and current trends

The prosthetic considerations for treatment of partially edentulous patients involve evaluation of important aspects such as presence of certain functional or skeletal deficits, orientation of the occlusal plane, free-way space, size and location of edentulous areas, number, strategic location and quality of the likely abutment teeth, vertical dimension, and the type of occlusion. A comprehensive evaluation, multidisciplinary approach and a sequential treatment plan, worked out in harmony with the patient's perceptions are important factors to ensure a successful outcome. This article discusses the principles, current trends and importance of clinical decisions in designing a treatment strategy when confronted with complex situations of partial edentulism.