Post on 31-Dec-2015
Oral Rehabilitation of a Patient with Chronic Periodontitis
In partial fulfilment of BTech: Dental Technology, Dental Sciences, Tygerberg Campus, CPUT,
2008 Presented by Abduraghmaan Ismail
Overview
Patient background Treatment options for maxillary arch Treatment of choice for maxillary arch Treatment options for mandibular arch Treatment of choice for mandibular arch Clinical procedures for maxillary arch Clinical procedures for mandibular arch Laboratory procedures for maxillary arch Laboratory procedures for mandibular arch References Acknowledgements
Periodontitis
Fig.1 Adult periodontitis1 Fig. 2 Periodontitis after surgery1
Patient Background
45 year-old male Excessive smoker
Main complaint is poor aesthetics Patient wants best possible treatment options Middle income group Patient has chronic periodontitis2,3
Maxillary teeth extracted {1·3, 1·4, 1·5, 1·6, 2·3, 2·4, 2·6, 2·7} All mandibular teeth extracted
Periodontitis in Maxillary and Mandibular Arches The patients’ dentitionprior to extraction (Fig.3)
A. Allie
Periodontitis in Mandibular Arch
A. Allie
Patient’s dentition prior to extraction (Fig. 4)
Treatment Options for Maxillary Arch
Extract remaining teeth, replace with acrylic denture
Restore teeth with fixed prosthesis, partial denture for edentulous spaces4
Restore remaining teeth, replace with all- ceramic bridge5
Treatment Option of choice for Maxillary Arch Restore remaining teeth 1·7, 2·1, 2·8
A prosthesis fabricated for prepared teeth4
A partial prosthesis for edentulous spaces6
Treatment Options for Mandibular Arch A full mandibular acrylic denture7
Implant retained ceramic bridge8
Treatment Option of choice for Mandibular Arch Mandibular acrylic denture with personalised
tinting7
Most viable option, excellent success rate; and more affordable for patient
Clinical ProceduresMaxillary Arch Root canal therapy to 1·7, 2·1, 2·8
1·7, 2·1, 2·8 prepared for prostheses
2·2 will be extracted
Clinical Procedures for Mandibular Arch Impressions for fabrication of mandibular
prosthesis9,10
Followed by accurate bite registrations9,10
Wax try-in of mandibular denture10
Placement of finished denture by dentist10
Laboratory Procedures for Maxillary Arch PFM restoration for 2·111,12,13
Full gold crowns with precision milled seats
for attachment of RPD on 1·7, 2·84,6,14
Co-Cr RPD replaces missing teeth6,15,16
Laboratory Procedures for Mandibular Arch Pouring impressions - primary and final
Record block fabrication
Set-up and wax-up of try in
Finishing and polishing with personalised denture tinting7,9,12
Maxillary Prosthesis
Fig. 5 Palatal view of maxillary prosthesis
Ismail
Mandibular Prosthesis
Du Preez
Fig.6 Completed mandibular prosthesis
Completed Prosthesis
Du Preez
Fig. 7 Articulated prosthesis
References
1. Lindhe J. Clinical Periodontology and Implant Dentistry. 4th ed. Oxford: Blackwell Publishing Co. 2003: 47-53.
2. MayoClinic.com-Tools for Healthier Lives. Available: http://www.mayoclionic.com/health/periodontitis 26 July 2008
3. Oral Health-Common Problems-All About Periodontitis. Available: http://www.health24.com/medical/condition_centres 26 July 2008.
4. Smith GNB. Planning and Making Crowns and Bridges. 3rd ed. London: Martin Dunitz Ltd. 1998: 24-25.
5. Van Noort R. Introduction to Dental Materials. 2nd ed. Edinburgh: Elsevier Science Ltd. 2002: 180, 238, 240.
6. Wulfes H. Precision Milling and Partial Denture Constructions - A Manual. 1st ed. Bremen: Academia Dental International School BEGO Germany. 2004: 57-59; 138; 195.
References cont.
7. Muraoka H. A Colour Atlas of Complete Denture Fabrication. Chicago: Quitessence Publishing Company. 1989: 41-43.
8. Babbush CA. Dental Implants - The Art and Science. Philadelphia: W B Saunders Company. 2001: 3-19.
9. Morrow RM, Rudd KD, Rhoads JE. Dental Laboratory Procedures-Complete Dentures. Volume 1. St. Louis: The CV Mosby Company. 1986: 223-240, 312-320.
10. Basker RM, Davenport JC. Prosthetic Treatment of the Edentulous Patient. 4th ed. Oxford: Blackwell Publishing co. 2002: 146-241.
11. Roberts DH. Fixed Bridge Prostheses. 2nd ed. London: John Wright and Sons Ltd. 1980: 129-130, 139-140, 166.
References cont.
12. Mclean JW. The Science and Art of Dental Ceramics. Volume 1 - The Nature of Dental Ceramics and their Clinical use. Chicago: Quintessence Publishing Co. 1979: 23-28, 37-39.
13. Dykema RW. Johnston’s Modern Practice in Fixed Prosthodontics. 4th ed. Philadelphia: W.B Saunders Company. 1986: 8-16, 22-25, 60-63.
14. Jenkins G. Precision Attachments- A Link to Successful Restorative Treatment. London: Quintessence Publishing Co. Ltd. 1999: 33-40.
15. Stewart KL. Clinical Removable Partial Prosthodontics. St. Louis: The CV Mosby Company. 1983: 18-20; 56-60.
16. Anusavice KJ. Phillips’ Science of Dental Materials. 10th ed. Philadelphia: WB Saunders Company. 1996: 237.
Acknowledgements
Dr. A. Allie, UWC Ziyaad Williams, UWC Gerhard Du Preez, CPUT Timothy Peterson, CPUT
Thank You