Multidisciplinary Approach for Full-Mouth Rehabilitation of a Young Adult Patient with Ameloblastoma

Ameloblastoma is a benign but locally invasive neoplasm of the odontogenic epithelium that tends to grow slowly in the mandible or maxilla. It can be highly destructive to the surrounding dental anatomy and can cause death by progressive spread to nearby vital structures in rare cases. Marginal resection is the most effective method of eliminating the tumor, but treatment can further contribute to oral and dental deformity and malfunction. This clinical report describes the dental rehabilitation of a young adult patient diagnosed with ameloblastoma and underwent preliminary marsupialization, segmental mandibulectomy, and fibula free flap reconstruction, followed by mandibular dental implant placements. Orthodontic and rapid palatal expansion for maxillary arch correction was also performed. The treatment goal of regaining dental function and a satisfactory appearance was accomplished.

Full Mouth Rehabilitation – The Enigma Continues

‘ No thi ng Ch an ge s i f No t hi ng Ch an ge s’ Treating a case of full mouth rehabilitation has remained a challenge till date. Dentistry has witnessed many advancements in terms of material science, technology and treatment procedures. What has not evolved is the thought process of application of these newer methods and technology. Any treatment procedure performed on a patient is not a straightforward mathematical calculation which can be implemented in a specified manner. Clinical processes, especially a case of full mouth rehabilitation requires comprehensive knowledge and understanding of the stomatognathic system. The word rehabilitation in itself conveys responsibility. A lot is involved at both the ends - the receiver (patient) and the donor (the rehabilitation specialist). The oxford dictionary defines rehabilitation as ‘The action of restoring someone to health or normal life through training and therapy after imprisonment, addiction, or illness.’ 1 It is a great responsibility on restoring dentist to bring the abnormal and compromised oral functions back on track. The multidisciplinary dimension of the treatment cannot be ignored. Although the culmination of an elaborate treatment is by a restoring specialist which happens to be prosthodontist most of the time, other specialists such as endodontist, periodontist, oral surgeon, orthodontist and an oral radiologist play a significant role throughout the planning and execution. It is advisable to seek expert opinion and include specialty procedures whenever deemed necessary.

Laboratory Characterization of In-Service Full-Mouth Rehabilitation with Monolithic Translucent Zirconia Restorations

The chance to critically and microscopically inspect the quality of bonded restorations once they are delivered to the patient after several pre-cementation steps is rare or nonexistent. Replicas of in-service restorations can provide a wealth of information on the integrity of the restorations and moreover make it possible to bring this information to the laboratory for further detailed analysis. This study aimed to characterize the epoxy replicas of 27 cemented monolithic yttria-stabilized zirconia crowns of the maxillary and mandibular arch to assess surface roughness, topography, and symmetry. The topography of the facial, lingual, and occlusal/incisal surfaces of each crown was observed under the optical microscope and further characterized using the scanning electron microscope. Surface roughness measurements were performed using the atomic force microscope. The optical microscope was used to measure the golden proportion and visible width of the anterior maxillary crowns. Surface damage consistent with unpolished adjustment was identified mostly in the occlusal surface of the posterior teeth. Other irregularities, such as scratch marks, small pits, and coarse pits were also found. The surface roughness had great variability. Not all of the anterior maxillary and mandibular teeth followed the golden proportion concept. This study design allows in vitro characterization of in-service restorations. It provides a framework for using replicas for early identification of patterns or features that can trigger fracture and for analysis of morphology and symmetry.

Full mouth rehabilitation for severely worn dentition using fixed prostheses and tooth-supported partial overdenture: a case report.

Rehabilitation of severely worn dentition represents a significant clinical challenge, especially when the restorative space is not sufficient. Creating restorations that fulfil the aesthetic, occlusal and functional parameters are essential to long-term success. This case report describes a 48-year-old male, who had severely worn dentition, which resulted in collapsed vertical dimension. The initial treatment involved careful planning, stabilization of existing dental diseases and construction of provisional prostheses at increased vertical dimension. Once the compatibility of the new vertical dimension had been confirmed, permanent reconstruction was performed. As with all full mouth prosthetic rehabilitation cases, equal-intensity centric occlusal contacts on all teeth and an anterior guidance in harmony with functional jaw movements were critically taken into account in each treatment phases.

Comprehensive Management of Severe Dental Fluorosis with Adhesively Bonded All-Ceramic Restorations

Dental fluorosis is a common disorder caused by excessive fluoride intake during tooth development. The esthetic consequences of dental fluorosis can negatively affect oral health-related quality of life and have lasting psychosocial effects. In severe cases, where the fluorosed enamel is prone to chipping, flaking, and developing caries, minimally invasive procedures are ineffectual and a more substantial restorative approach is required to restore optimal function and esthetics. However, no definitive guidelines exist for the management and treatment of severe dental fluorosis due to the limited evidence available in the literature. This case report describes the full-mouth rehabilitation of a patient with severe dental fluorosis utilizing adhesively bonded all-ceramic crowns, veneers, and overlays. The successful follow-up on this case indicates that adhesively bonded restorations may provide a viable option in the functional and esthetic management of severely fluorosed dentition.