J Korean Acad Prosthodont.  2017 Apr;55(2):156-163. 10.4047/jkap.2017.55.2.156.

Full mouth rehabilitation of edentulous patient with intellectual disability using implants and monolithic zirconia

Affiliations
  • 1Department of Prosthodontics and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Republic of Korea. ksh1250@snu.ac.kr

Abstract

People with class I intellectual disability need lifelong assistance and protection from their surroundings due to impaired adaptive functioning. They have poor oral health and show higher prevalence of dental caries, periapical inflammation and tooth loss that require proper prosthetic restoration. Because removable prostheses for intellectually disabled patients often lack stability, retention, and maintenance, fixed prostheses are essential and the only available option is dental implants. In this case, a 45 year-old male patient with class I intellectual disability had poor oral hygiene with most of his teeth missing and visited the clinic to recover his masticatory function. Due to such systemic conditions, the definitive restoration of choice was the implant-supported fixed dental prosthesis made of biocompatible and highly strong monolithic zirconia. In consequence of the treatment process, the patient was able to improve his oral environment aesthetically and functionally.

Keyword

Intellectual disability; Zirconia; Full mouth rehabilitation

MeSH Terms

Dental Caries
Dental Implants
Dental Prosthesis
Humans
Inflammation
Intellectual Disability*
Male
Mouth Rehabilitation*
Mouth*
Oral Health
Oral Hygiene
Prevalence
Prostheses and Implants
Tooth
Tooth Loss
Dental Implants

Figure

  • Fig. 1. Initial intraoral photographs. (A) Maxillary occlusal view, (B) Frontal view, (C) Mandibular occlusal view.

  • Fig. 2. Initial panoramic radiograph of the patient.

  • Fig. 3. The CBCT images at the maxilla. (A) #16, (B) #15, (C) #13, (D) #26.

  • Fig. 4. The CBCT images at the mandible. (A) #46, (B) #44, (C) #43, (D) #31, (E) #33, (F) #34, (G) #36.

  • Fig. 5. The surgical manipulations performed under general anesthesia. (A) Tooth preparation, (B) Implant surgery (Maxilla), (C) Implant surgery (Mandible).

  • Fig. 6. Radiographs of the patient. (A) Immediately after surgery, (B) After 1 month.

  • Fig. 7. Provisional prostheses. (A) Maxillary occlusal view, (B) Lateral view (right), (C) Frontal view, (D) Lateral view (left), (E) Mandibular occlusal view.

  • Fig. 8. Definitive prostheses (CAD/CAM monolithic zirconia). (A) Maxillary occlusal view, (B) Lateral view (right), (C) Frontal view, (D) Lateral view (left), (E) Right working movement, (F) Mandibular occlusal view, (G) Left working movement.

  • Fig. 9. Panoramic radiograph of the patient after treatment.


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