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Mouth rehabilitation calls for the greatest skills we possess as dentists. We have a moral and professional responsibility to our patients to do what is best for them. This can only be achieved by careful checking and cross-checking of our procedures during fabrication. Transitional prostheses, therefore, may serve as a valuable adjunct toward the achievement of success in mouth rehabilitation.
The concepts of traditional full mouth reconstruction have been reviewed. A practical full mouth rehabilitation technique has been described combining the chairside advantages of the programmed quadrant reconstruction with the laboratory advantages associated with the complete mouth simultaneous rehabilitation.
The literature is replete with theories regarding temporomandibular disorders (TMD). However, there is a paucity of information concerning perceived malocclusion and other teeth-related signs and symptoms after full-mouth rehabilitation. This clinical study was designed to evaluate the perception of TMD patients concerning perceived malocclusion and other teeth-related signs and symptoms after full-mouth rehabilitation guided by the Mental Analog Scale (MAS). Among 38 patients referred for full-mouth rehabilitation, 20 were diagnosed as having TMD after reviewing a questionnaire, recording the major complaints and symptoms, in addition to performing comprehensive clinical examination. Nonsurgical therapy was performed, including fabricating an anterior programming device, a centric relation occlusal device and finally full-mouth rehabilitation by means of placing crowns on all upper and/or lower teeth. All full-mouth rehabilitation procedures were performed using a fully adjustable articulator and mandibular movements were recorded following pantographic tracings. After full-mouth rehabilitation, the patients were followed up at 1, 2, 4, 6, 9, and 12-month intervals, and the major signs and symptoms were recorded along with adjunctive teeth-related signs and symptoms. Fisher exact probability tests were applied to analyze the results (P<.05). Statistical comparisons of the MAS responses before and after treatment (at 1-month recall) showed significant improvement (P<.05) for all teeth-related signs and symptoms except for bruxism (P=.0699). Further improvement was noted at the 4-month recall period. However, these improvements were not statistically significant for all teeth-related signs and symptoms. No further change was noted after the 4-month recall period. There was a marked reduction in perceived malocclusion and adjunctive teeth-related signs and symptoms during function, only after performing occlusal equilibration of the final restorations.
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This case report covers the combined functional and perioprosthetic complete-mouth rehabilitation of a 67-year-old patient with severe temporomandibular joint pain caused by a prognathic forced incorrect centric relation and severe overclosure. Once bite guard treatment had been concluded and the pain had subsided completely, AGC electroformed crown and bridgework was fabricated. Electroformed crown-and-bridge copings exhibit extremely high precision of fit and, from the clinical point of view, perfect esthetics. As the coping material is pure gold and there are no bonding oxides in the gold-porcelain bonding layer, AGC restorations are readily integrated into the biologic structures around the crown margins. Perfectly healthy, noninflamed soft tissues, a lack of bluish-livid colored gingival margins, and visible gingival reattachment around the crown margins are considerable benefits from the perioprosthetic point of view. This leads to foreseeable clinical success and promises further use of electroformed porcelain restorations.
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Anorexia and bulimia nervosa are eating disorders seen mainly in adolescents or young patients. The dentist should be in the position to recognize early signs of the disorder and alert the patient (and the patient's parents, if necessary) of the possible physical, psychologi cal, and dental consequences. Such dental treatment may help motivate the patient to confront the problem. In this paper the full-mouth rehabilitation, using a combination of galvano- and metal-ceramic restorations, of a young patient suffering from bulimia nervosa is described.
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