Full mouth rehabilitation of an oligodontia patient with intellectual disability based on shortened dental arch concept: a case report

Jae-Wook You; Seong-Joo Heo; Seong-Kyun Kim; Jai-Young Koak

doi:10.4047/jkap.2012.50.4.330

Journal List > J Korean Acad Prosthodont > v.50(4) > 1034725

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

You, Heo, Kim, and Koak: Full mouth rehabilitation of an oligodontia patient with intellectual disability based on shortened dental arch concept: a case report

Case Report

The Journal of Korean Academy of Prosthodontics

The Journal of Korean Academy of Prosthodontics 2012; 50(4): 330-335.

Published online: 31 October 2012

DOI: https://doi.org/10.4047/jkap.2012.50.4.330

Full mouth rehabilitation of an oligodontia patient with intellectual disability based on shortened dental arch concept: a case report

Jae-Wook You, DDS, MSD, Seong-Joo Heo, DDS, MSD, PhD, Seong-Kyun Kim, DDS, MSD, PhD, Jai-Young Koak, DDS, MSD, PhD

Department of Prosthodontics, School of Dentistry, Seoul National University, Seoul, Korea.

Corresponding Author: Jai-Young Koak. Department of Prosthodontics, School of Dentistry, Seoul National University 28 Yeongun-Dong, Chongro-Gu, Seoul, 110-749, Korea. +82 2 2072 2661: young21c@snu.ac.kr

Received 27 September 2012 Revised 12 October 2012 Accepted 14 October 2012

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Shortened dental arch (SDA) as a treatment goal is the concept that stable occlusion and enough masticatory force can be achieved by restoration to the second premolars when the situation is not favorable. SDA could be applied both natural teeth and implant supported fixed prostheses. This case dealt with a patient who has grade 2 intellectual disability and a lot of missing teeth. Because of intellectual disability, patient cooperation during treatment could not be expected. Therefore every treatment should be done under general anesthesia. In addition to that, ridge resorption around molar area was severe and there were maxillary sinus pneumatization and maxillary sinusitis which increased failure probability. SDA concept was adopted to reduce risk factor and minimize general anesthesia. After the treatment, functional and esthetic improvement was achieved and oral hygiene was fortified by periodic recall check and education.

Keywords: SDA, Intellectual disability, Full mouth rehabilitation

Figures and Tables

Fig. 1

Initial photo (frontal view). Loss of VD, supraeruption of #15, dento-alveolar protrusion and severe resorption of mandibular molar region can be observed.

Fig. 2

Initial photo (upper and lower occlusal view. A: maxilla, B: mandible). Bucco-lingual resorption of edentulous region, remaining caries of mandibular anterior teeth and the fistula in the labial gingiva of #42 can be observed.

Fig. 3

Initial panoramic view. Resorption of alveolar bone and maxillary sinus pneumatization can be observed.

Fig. 4

Diagnostic wax-up. Supraeuption of #15 and dentoalveolar protrusion of mandibular anterior teeth could be identified and the necessity of gingivectomy of #23 and CLP of #15, 31, 32, 33, 41 was verified.

Fig. 5

CT image of maxilla. Narrow ridge and inadequate length of height around #14 and maxillary sinusitis can be observed.

Fig. 6

CT image of mandible. Despite enough height, narrow width of alveolar bone made GBR necessary.

Fig. 7

Implant surgery. GBR was done at both maxilla and mandible (A: maxilla, B: mandible).

Fig. 8

Gingevectomy of #23, CLP of #15, 31, 32, 33, 42 and extraction of #42.

Fig. 9

Healing after gingivectomy and CLP. Relatively regular gingival height and enough clinical crown length of mandibular anterior teeth were attained.

Fig. 10

Tooth preparation and customized abutment.

Fig. 11

Provisional restoration.

Fig. 12

Bite registration. Pattern resin copings which were relined by bite material at one side were connected remaining provisional restorations at the other side and vice versa.

Fig. 13

Coping try-in.

Fig. 14

Final restoration (frontal view).

Fig. 15

Final restoration (upper and lower occlusal view).

Notes

This research was supported by the Bio & Medical Technology Development Program of the National Research Foundation (NRF) funded by the Korean government (MEST) (No. 2011-0027790).

References

1. Kanno T, Carlsson GE. A review of the shortened dental arch concept focusing on the work by the Käyser/Nijmegen group. J Oral Rehabil. 2006. 33:850–862.

2. Witter DJ, De Haan AF, Käyser AF, Van Rossum GM. A 6-year follow-up study of oral function in shortened dental arches. Part II: Craniomandibular dysfunction and oral comfort. J Oral Rehabil. 1994. 21:353–366.

3. Witter DJ, de Haan AF, Käyser AF, van Rossum GM. A 6-year follow-up study of oral function in shortened dental arches. Part I: Occlusal stability. J Oral Rehabil. 1994. 21:113–125.

4. Solow RA. Comprehensive implant restoration and the shortened dental arch. Gen Dent. 2010. 58:390–399.

5. Armellini D, von Fraunhofer JA. The shortened dental arch: a review of the literature. J Prosthet Dent. 2004. 92:531–535.

TOOLS

Similar articles