J Dent Rehabil Appl Sci.  2015 Sep;31(3):253-261. 10.14368/jdras.2015.31.3.253.

Full mouth rehabilitation with a few remaining teeth and implants for a patient with chronic periodontitis: a case report

• Shin EJ
• Vang MS
• Yang HS
• Park SW
• Lim HP
• Yun KD

• KMID: 2180027
• DOI: http://doi.org/10.14368/jdras.2015.31.3.253

Abstract

Chronic periodontitis involves subsequent loss of teeth, and if left untreated, can lead to adjacent teeth drifting and supraeruption of the rest dentition. Careful consideration has to be given when deciding extraction of remaining teeth in treatment of periodontally compromised dentitions. For tooth-supported fixed partial dentures or removable partial dentures, periodontally compromised teeth are extracted due to possible early failure from functional overload, but for implant restoration, the teeth could be used as supports for fixed partial dentures because implants can reduce overload on teeth. The remaining natural teeth can help clinicians restoring vertical dimension and normal occlusal plane in full mouth rehabilitation because it conserves patients' proprioceptive response. This clinical report describes treatment of a patient who has a few remaining teeth and supraeruption of the rest dentition from severe chronic periodontitis. Satisfactory clinical result was achieved with full mouth rehabilitation using a few teeth and implants.

Keyword

chronic periodontitis; a few remaining teeth; dental implants; mouth rehabilitation

MeSH Terms

Chronic Periodontitis*
Dental Implants
Dental Occlusion
Dentition
Denture, Partial, Fixed
Denture, Partial, Removable
Humans
Mouth Rehabilitation*
Mouth*
Tooth*
Vertical Dimension
Dental Implants

Figure

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  Fig. 1 Panogramic radiograph at first visit; Multiple teeth loss, shifting teeth, supraeruption of the rest dentition and severe periodontitis.

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  Fig. 2 Extraoral photos at first visit. (A) Frontal view, (B) Side view.

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  Fig. 3 Implant installation; Panoramic view. #17i, 16i, 45i, 47i: US II Φ5.0 × 11 mm, #14i, 24i: US II Φ4.0 × 10 mm, #26i, 27i: US II Φ4.5 × 11 mm, #33i, 43i: US II Φ3.5 × 11 mm, 13i, 11i, 23i: TS Φ3.5 × 11.5 mm (Osstem, Busan, Korea).

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  Fig. 4 Impression for provisional restoration. (A) Maxillary occlusal view, (B) Mandibular occlusal view.

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  Fig. 5 Provisional restoration. (A) Balancing side during left lateral excursion, (B) Maxillary occlusal view, (C) Working side during left lateral excursion, (D) Right buccal view during centric occlusion, (E) Frontal view during centric occlusion, (F) Left buccal view during centric occlusion, (G) Working side during right lateral excursion, (H) Mandibular occlusal view, (I) Balancing side during right lateral excursion.

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  Fig. 6 Intermaxillary relation registration for cross mounting.

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  Fig. 7 Check bite registration. (A) Left excursion, (B) Anterior guidance, (C) Right excursion.

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  Fig. 8 Mounting on a semi-adjustable dental articulator. (A) Facebow transfer, (B) Cross mounting on a articulator.

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  Fig. 9 Definitive restoration. (A) Balancing side during left lateral excursion, (B) Maxillary occlusal view, (C) Working side during left lateral excursion, (D) Right buccal view during centric occlusion, (E) Frontal view during centric occlusion, (F) Left buccal view during centric occlusion, (G) Working side during right lateral excursion, (H) Mandibular occlusal view, (I) Balancing side during right lateral excursion.

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  Fig. 10 CT for condylar joint space. (A) Right condyle, (B) Left condyle.

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  Fig. 11 EPA test by ARCUS digma II. MICP: 1, 2, 3; CR (manipulation): 4, 5, 6.

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  Fig. 12 Postoperative panoramic radiograph.

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  Fig. 13 Postoperative extraoral photos. (A) Frontal view, (B) Side view.

Reference

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