Accelerated esthetic dental results using an interdisciplinary approach.

Traditionally, achieving case acceptance in situations that involve orthodontics has been challenging for clinicians, especially among adult male patients. In recent years, surgically accelerated orthodontics has emerged as an alternative approach for patients who might otherwise avoid treatment or choose a compromised form of treatment due to esthetic concerns about wearing traditional braces. In this case report, use of an interdisciplinary approach that combined Kois diagnostic principles with Accelerated Osteogenic Orthodontics (AOO) and lingual braces resulted in a successful restoration while maintaining satisfactory esthetics during treatment.

Controlling the periodontal-restorative interface to provide esthetic dentistry for an esthetically high-risk patient.

This case involved a young female patient with anterior wear and a high lip line and thin tissue biotype. An organized approach was carried out to diagnose the esthetic problems so that a multidisciplinary treatment plan could be devised. The comprehensive plan included occlusal analysis and equilibration to establish maximum intercuspation in harmony with centric relation, correction of gingival levels, feldspathic porcelain restorations, and teeth bleaching. The case demonstrates technological advances and improvement in dentistry's understanding of the science of color and dental ceramics.

Management of the severely worn dentition with different prosthetic rehabilitation methods: a case series.

Clinicians are often faced with the challenge of restoring a severely worn dentition. Esthetic and functional rehabilitation of patients in this condition represents a noteworthy clinical challenge. Although treatment options for the severely worn dentition with reduced occlusal vertical dimension can be limited, providing a functional and esthetic restoration in these situations is crucial for restoring the patient's quality of life. Different treatment approaches for the rehabilitation of worn dentition are presented in this case series.

Rehabilitation of Severely Attrited Teeth with Hobo Twin Stage Technique: A Case Report.

Restoration of excessively worn dentition is a challenging treatment procedures. It requires efficient diagnosis and treatment plan. Hobo's techniques and Pankey Mann Schuyler's philosophy are widely used and documented for full mouth rehabilitation. We have reported the case of a 56-year- old male patient who presented with the severely worn dentition and had difficulty in chewing. To rehabilitate this case Hobo's twin stage technique had been adopted as it is based on scientific data and mathematical analysis for both disocclusion and anterior guidance thus reducing chair side time. Keywords: attrited; hobo; occlusion; rehabilitation.

Altering occlusal vertical dimension provisionally with base metal onlays: a clinical report.

This article presents a method for altering occlusal vertical dimension (OVD) to restore dentitions with limited restorative space due to loss of tooth structure. A provisional increase in OVD is achieved using predominately base metal onlays, which offer advantages over conventional techniques. The onlays are resistant to wear, may be bonded well to nonrestored and restored tooth surfaces with resin cements, and provide a fairly reversible method of increasing OVD. A patient situation is presented which demonstrates the use of provisional base metal onlays in complete mouth rehabilitation.

[Short-term and long-term effects of occlusal rehabilitation on the co-contractration patterns of the electromyography of masticatory muscles].

OBJECTIVE: To investigate the short-term and long-term effects of occlusal rehabilitation on the co-contractration patterns of masticatory muscles of patients with extensive tooth wear. METHODS: Twenty-nine patients with severe tooth wear were selected and conducted with occlusal rehabilitation. The surface electromyography (EMG) of masseter (MM), anterior temporalis (TA) and posterior temporalis (TP) at rest position, during clenching and chewing were separately recorded in the stage of pre-treatment, 1 month after temporary restoration, 1 month after permanent restoration and long-term observation (mean 3.5 years). The Asymmetry Indexes (AI) of bilateral muscles, Activity Indexes of MM/TA, MM/TP and TA/TP were compared in each stage. RESULTS: (1) After occlusal rehabilitation, all the AIs of bilateral MM, TA and TP at rest position, during clenching and chewing showed obvious decrements. (2) In every stage of occlusal rehabilitation, all of the Activity Indexes of MM/TA at rest position, during clenching and chewing had no obvious changes. (3) The Activity Indexes of MM/TP and TA/TP during clenching and chewing significantly increased after occlusal rehabilitation. CONCLUSION: The treatment of occlusal rehabilitation can significantly improve the bilateral symmetry of masticatory muscles in patients with extensive tooth wear, and also change the coordinated EMG activity of different masticatory muscles.

Maxillary and mandibular overlay removable partial dentures for restoration of worn teeth. A three-year follow-up.

This clinical report describes the fabrication and a three-year follow-up of maxillary and mandibular cast overlay removable partial dentures for the restoration of severely worn dentition with accompanying loss of vertical dimension of occlusion. The frameworks supported porcelain veneers for esthetics, and metal occlusal surfaces for strength and durability.

Esthetic rehabilitation of a worn dentition with a minimally invasive prosthetic procedure (MIPP).

A minimally invasive prosthetic procedure (MIPP) for the esthetic rehabilitation of the complete arch advocates the preservation of enamel to optimize the adhesive bond of the luting agent to both the tooth surface and the etchable ceramic restoration. When esthetic rehabilitation of a worn dentition is required, a MIPP can be selected to reduce the biological cost of removing additional enamel tooth structure. The fundamental steps to achieve this goal are to: (1) increase the vertical dimension of occlusion (VDO); (2) reduce the thickness of the monolithic ceramic material; (3) preserve the enamel during tooth preparation; and (4) adhesively bond the etchable ceramic restorations. This article presents a comprehensive, minimally invasive prosthetic treatment approach for the esthetic rehabilitation of a severely worn dentition using a lithium disilicate all-ceramic material with partial and complete coverage restorations.

Transitional bonding for segmented treatment: a two-phase restorative approach.

When extensive dental therapy is needed, as in cases of severe attrition, interim restorations are useful in determining whether or not the proposed treatment will be successful. Transitional resin bonding is one type of interim method. In this case report, a 60-year-old patient presented with severely worn maxillary and mandibular anterior teeth; he desired treatment to be done in a timely fashion so as to be ready to attend an important wedding. Due to the urgency in timing and the complexity of the case, the treatment plan was a two-phase approach that included an initial esthetic and occlusal design to create a diagnostic wax-up followed by placement of transitional composite resin bonding, and then placement of indirect porcelain restorations. This transitional bonding approach allowed comprehensive treatment to be completed at a pace suitable to the patient's needs.

Removable prostheses.

Reconstruction of the dentition extensively damaged through tooth surface loss may require the use of removable prostheses. This can be the most appropriate type of treatment when either the teeth are very severely worn or the patient wishes a simpler and more economical approach than a fixed reconstruction.

How to preview esthetics and test occlusion in vivo prior to performing restorative dentistry.

The technique discussed in this article tests occlusion, esthetics, and phonetics prior to starting restorative dentistry.

Dental management of severe dentinogenesis imperfecta in a mild form of osteogenesis imperfecta.

Dentinogenesis Imperfecta (DI), in which the teeth are discolored, translucent and brittle, can occur in isolation as a familial trait and as a component of the skeletal dysplasia Osteogenesis Imperfecta (OI). In a Cape Town family, 20 persons in 3 generations had mild OI, with the additional manifestation of severe DI. The family was assessed at the Dental Genetic Unit of the University of the Western Cape and appropriate dental treatment was provided. In this setting, a detailed treatment plan was devised for a severely affected woman. This plan proved to be efficient and cost effective, and the final outcome was pleasing to the patient. Dentinogenesis Imperfecta is not uncommon and may well be encountered in conventional dental practice. The necessary clinical expertise is within the scope of the skills of the general dentist.

The long-term management of patients with tooth surface loss treated using removable appliances.

The causes of tooth surface loss are multi-factorial and hence can be difficult to eradicate. This paper identifies the problems that may be anticipated during the long-term management of patients where tooth surface loss has been treated using removable appliances, where the number of teeth is often reduced. Wear and tear are inevitable and patients should therefore be made fully aware of the possibility of the gradual deterioration and failure of restorative work. Treatments should be planned, which would enable the dentist to recover the situation, with minimal inconvenience to the patient.

Partial dentures for patients with advanced tooth wear.

Many patients attend their dentist for advice, and often treatment, for tooth wear. Poor appearance and inadequate function are the most common presenting complaints but occasionally treatment is needed for acute or chronic pain or sensitivity. Although patients often prefer a fixed replacement for the missing tooth structure this is not always possible or appropriate. This article presents the practical aspects of managing patients with advanced tooth wear using removable partial dentures.

[Adoption of the condyle position of patients with extensive tooth wear during occlusal rehabilitation].

OBJECTIVE: To evaluate the adoption of the condyle position of patients with extensive tooth wear during occlusal rehabilitation, and the correlation between increased vertical dimensions and the changes of joint spaces. METHODS: Twenty-seven patients (five from Beifang hospital, others from Peking University School and Hospital of Stomatology) with extensive tooth wear were selected and received occlusal rehabilitation treatment. The radiographs of standard Schüllers position were taken before treatment (stage 1), 1 month following delivery of temporary restoration (stage 2), and 1 month following delivery of permanent restoration (stage 3). RESULTS: The superior, anterior and posterior joint spaces were (3.24 ± 0.16), (2.06 ± 0.11), (1.89 ± 0.13) mm at stage 1; (3.61 ± 0.15), (1.94 ± 0.10), (2.52 ± 0.11) mm at stage 2; (3.49 ± 0.19), (1.93 ± 0.10), (2.40 ± 0.13) mm at stage 3. The posterior joint spaces at stage 2 and stage 3 were significantly larger than that at stage 1(P < 0.01). The superior spaces at stage 2 were significantly larger than that at stage 1 (P < 0.05). No correlations between the increased vertical dimensions and the changes of joint spaces were found in the three stages (P > 0.05). CONCLUSIONS: The condyle positions in the patients with extensive tooth wear changed after occlusal rehabilitation.

Dentinogenesis imperfecta: long-term rehabilitation in a child.

The treatment of dentinogenesis imperfecta represents a challenge for the dental practitioner. The aim of this case report was to describe the chronology and problems encountered in the long-term rehabilitation of a young girl suffering from dentinogenesis imperfecta with severe attrition. A 2-stage treatment over a period of 9 years is described and discussed. This treatment comprised an initial treatment to restore esthetic appearance and function during primary and mixed dentitions and a complete prosthetic rehabilitation in a second stage to protect permanent teeth with low-fusion ceramicmetal individual crowns. Discovery of a follicular cyst is also reported and its treatment is described.

Treatment of a patient with severely worn dentition: a clinical report.

This clinical report documents the prosthodontic treatment of a Prosthodontic Diagnostic Index Class IV 63-year-old white male, referred to the prosthodontic clinic by his general dentist for evaluation and treatment. The patient was concerned about the severe wear on his teeth and understood the need for comprehensive (full-mouth) rehabilitation to restore his dental condition. The clinical findings, diagnosis, treatment plan, and sequence of treatment are presented.