J Korean Acad Prosthodont.  2013 Oct;51(4):339-346. 10.4047/jkap.2013.51.4.339.

Interdisciplinary approach on oral rehabilitation of an adolescent patient with multiple missing teeth: a clinical report

• Kwon KR
• Paek J
• Kim HW

• KMID: 2000159
• DOI: http://doi.org/10.4047/jkap.2013.51.4.339

Abstract

In case of missing of permanent teeth by trauma or innate defect, the decision of treatment modalities and application timing have an important effect on the prognosis of oral rehabilitation. In this case report, interdisciplinary approach between the orthodontic and prosthodontic treatment, the way to re-establish the collapsed occlusal vertical dimension, and implant prosthetic considerations will be discussed. Proper diagnosis on teeth and craniofacial skeleton was made prior to treatment and provisional restorations were used in regard of growth patterns of the patient. Finally, the edentulous areas were restored with fixed implant prostheses. Diagnosis, treatment rationale and prognosis will be discussed thoroughly.

Keyword

Congenital missing; Oligodontia; Occlusal vertical dimension; Growth and development

MeSH Terms

Adolescent*
Growth and Development
Humans
Prognosis
Prostheses and Implants
Prosthodontics
Tooth*
Vertical Dimension

Figure

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  Fig. 1. Pre-operative panoramic radiograph (January 1999).

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  Fig. 2. Pre-operative intraoral photographs (March 1999).

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  Fig. 3. Diagnostic wax-up with proper crown contour and ratio.

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  Fig. 4. Maximum intercuspation with provisional restoration.

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  Fig. 5. Panoramic radiograph after endodontic treatment on maxillary anterior teeth and bone graft on mandibular defect area.

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  Fig. 6. Occlusal plane establishment (with KaVo occlusal plane plate).

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  Fig. 7. Intraoral photographs of final prosthesis.

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  Fig. 8. Panoramic radiograph of final prosthesis.

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  Fig. 9. Facial profile with final prosthesis.

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  Fig. 10. Panoramic radiograph with RSM (January 1995) and root resorption of first molar by erupting first premolar (January 1999).

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  Fig. 11. Occlusal plane establishment considering clinical crown length of maxillary and mandibular central incisor, vertical and horizontal overlap, height of first molar and height of retromolar pad.

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  Fig. 12. Direction of implantation should be parallel to the long axis of opposing teeth.

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