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Full Mouth Rehabilitation
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Introduction
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Full mouth rehabilitation cases are one of the most difficult cases to manage in
dental practice. This is because such cases involve not only replacement of the
lost tooth structure but also restoring the lost vertical dimensions. Full mouth
reconstruction is basically a set of procedures that are aimed at correcting an
improper bite position as well as restoring chipped or worn out teeth. Improper
jaw position is implicated in various neuro-muscular disorders as well as in headache
and neck ache. Correcting the jaw position not only restores proper function, but
also helps in enhancing the cosmetic appearance of the patient.
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Full mouth rehabilitation corrects imperfections in bite position and enhances the
appearance of the smile, like wornout, broken,discolored or chipped teeth. Full
Mouth Rehabilitation creates a smile that is functional, comfortable and beautiful.
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Full-mouth reconstruction, by its very nature can be extremely complex. Dental patients
who have many missing teeth or severe deterioration of most teeth, may require a
full mouth reconstruction using a combination of restorations, veneers, crowns,
bridges, dental implants or partial dentures. The oral cavity is a dynamic environment
where changes constantly occur, sometimes quickly but more often slowly over time.
Changes can be due to a traumatic accident, periodontal disease, shifting teeth,
a lifetime of neglect, a destructive habit such as grinding, or a lifetime of dentistry
focusing on one tooth at a time and leaving the mouth resembling a patchwork. Mouth
reconstruction, by its very nature can be extremely complex. Dental techniques and
technologies have come a long way in the past 30 years and patients are often surprised
by what can be done. Correct diagnosis and analysis is important to identify and
address the causes of the problems in the treatment plan. Treatment is often a non-surgical,
comprehensive approach to getting the upper and lower jaws in proper alignment,
removing all decay, repairing all chipped, weakened, and broken teeth, and ultimately,
creating a healthy, attractive smile that will last for many years.
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What are the Most Common Reasons For a Full-Mouth Meconstruction?
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Please alert the office if you have a medical condition that may be of concern prior
to surgery (i.e., diabetes, high blood pressure, artificial heart valves and joints,
rheumatic fever, etc.) or if you are currently taking any medication (i.e., heart
medications, aspirin, anticoagulant therapy, etc.).
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Patients requiring extensive restorative care frequently exhibit significant loss
of tooth structure. Specific clinical findings in an extremely worn dentition may
vary widely and are often confusing. Severe wear can result from a mechanical cause,
a chemical cause, or a combination of causes. The location of the wear, the accompanying
symptoms and signs, and information gained from the patient interview are essential
components in determining the etiology.
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Severe wear
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Excessive wear is often caused by hyperactive masticatory muscels and results in
unacceptable damage of the occluding surfaces of the teeth. This in turn may cause
a deterioration of structure of the front teeth, which are necessary for specific
protective guidance functions, phonetics, and aesthetics.
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Patients most at risk of dental erosion have work and sports dehydration, caffeine
addiction, gastro-oesophageal reflux, asthma, diabetes mellitus, hypertension or
other systemic diseases or syndromes that predispose to xerostomia (dry mouth).
Saliva protects the teeth from the extrinsic and intrinsic acids which cause dental
erosion. Erosion, exacerbated by attrition and abrasion, is the main cause of tooth
wear.
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Am I a Candidate?
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If you answer yes to any of the following statements, you are a candidate for Full
Mouth reconstruction :
- I have TMJ (temporomandibular joint syndrome)
- I experience frequent headaches or migraines
- I have unexplained loose teeth
- My teeth are worn, chipped or cracked
- My dental restorations frequently crack, chip or break
- I have pain or soreness around my jaw joints
- I have pain in my teeth that seems to move around
- I have facial, neck, shoulder and/or back pain
- There are clicking or grating sounds in my jaw joints
- I experience limited jaw movement or have locking jaw
- I have unexplained numbness in my fingers and arms
- I have unexplained congestion or stuffiness in my ears
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How It's Done ? |
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After through oral examination and considering etiology the dentist will decide
whether to treat with an orthodontic appliance, or to fit the patient with dental
restorations. The orthodontic is a removable or fixed appliance that artificially
builds up the patient's bite to a comfortable resting position. For few patients
with orthodontic treatment full mouth restoration is often required.
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Once this treatment is completed you can expect a mouth that looks great, feels
comfortable, and gives you the confidence to smile.The patient presented with inadequately
fitting upper partial denture and an incorrectly instituted treatment plan resulting
over a period of time: multiple loss of teeth that resulted in loss of jaw bone
and facial height resulting in an accelerated ageing appearance. We solved the problem
by improving the facial height (raising the bite), improving the upper smile line
using a combination of porcelain veneers, upper and lower precision milled, highly
aesthetic and firm partial dentures to restore the following:
- Facial and dental aesthetics
- Comfort
- Function
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For missing teeth here are, tooth replacement Options |
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This is often a difficult question. Some of the general advantages and disadvantages
of single to multiple tooth replacement options are listed below. |
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Advantages
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Disadvantages
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Removable Partial Dentures
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- Removable – good access for cleaning
- Cost effective
- Very minor tooth reduction required
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- Reduced comfort
- Possible clasp display
- Gaps visible on removal
- Patient intolerance
- Food traps, if not properly maintained, can cause dental caries
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Implant Replacement
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- No tooth reduction required
- Access for cleaning similar to natural teeth
- Failure can mean just loss of the implant ,and attached crown or bridge can mean
further tissue loss
- Minimal biological intervention compared to bridgework where adjacent teeth require
preparation
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- Requires minimal surgical intervention, similar to normal tooth removal
- More expensive, however compared to bridgework it is cheaper in the long term both
financially and biologically as all bridges fail at one point affecting one or more
of the retaining teeth, complicating future treatments
- Areas of large bone loss may require bone augmentation-grafting to improve ridge
anatomy/shape for better tooth emergence, function and aesthetics
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Fixed Bridgework
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- Good where adjacent teeth would benefit from crowns
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- Requires considerable tooth reduction (irreversible loss of usually all enamel and
supporting teeth) and risk of pulp death requiring root canal therapy.
- More difficult access for cleaning (risk of gum infection and tooth decay)
- Failure can mean considerable damage to supporting structures
- Similar cost to implants initially, however high biological cost
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