Full mouth prosthetic rehabilitation based on systemic analysis, diagnosis and treatment plan: a case report

Sooyeon Kwon; Janghyun Paek; Ahran Pae; Yi-Hyung Woo

doi:10.4047/jkap.2013.51.4.332

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Kwon, Paek, Pae, and Woo: Full mouth prosthetic rehabilitation based on systemic analysis, diagnosis and treatment plan: a case report

Case Report

J Korean Acad Prosthodont 2013;51(4):332-338.

Published online: NaN October 2013

DOI: https://doi.org/10.4047/jkap.2013.51.4.332

Full mouth prosthetic rehabilitation based on systemic analysis, diagnosis and treatment plan: a case report

Sooyeon Kwon, DDS, Janghyun Paek, DMD, MS, PhD, Ahran Pae, DMD, MSD, PhD, Yi-Hyung Woo, DMD, MSD, PhD^∗

Department of Prosthodontics, School of Dentistry, Kyung Hee University, Seoul, Korea

∗Corresponding Author: Yi-Hyung Woo Department of Prosthodontics, School of Dentistry, Kyung Hee University, Hoegi-Dong 1, Dongdaemun-Gu, Seoul, 130-701, Korea +82 2 958 9340: e-mail, yhwoo@khu.ac.kr

Received 7 August 201319 August 2013 Accepted 16 September 2013

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

Data collection including checking the problem list and analyzing the etiology cannot be overemphasized in full mouth rehabilitation cases. It is well reported that favorable prognosis of prosthodontic treatment depends on accurate diagnosis. Seventy seven year old female patient presented with chief complaints of chewing pain on maxillary and mandibular left premolars and unesthetic existing prosthesis. Clinical evaluation, radiographic examination and cast analysis were performed to gather comprehensive data and problem lists. Treatment planning was based on collected data and related articles. Abutment evaluation, prognosis depending on various types of prosthesis, and maintenance were considered as well. Occlusal vertical dimension was increased to solve esthetic dissatisfaction and insufficient interocclusal space. Patient adaptation was verified with provisional restorations followed by diagnostic wax up. Function, esthetics and occlusal stability were verified during 8 week follow-up period. Prosthodontic reconstruction based on systemic analysis, diagnosis, and treatment plan led to satisfactory result after delivery of definitive prosthesis. (J Korean Acad Prosthodont 2013;51:332-8)

Keywords: Systemic analysis, Full mouth rehabilitation, Occlusal vertical dimension

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Fig. 1.

Pre-operative intraoral photographs. A: Maxillary occlusal view, B: Mandibular occlusal view, C: Right lateral view, D: Frontal view, E: Left lateral view.

Fig. 2.

Panoramic radiographs.

Fig. 3.

CR-MICP discrepancy. A: 0.5 mm lateral discrepancy on frontal view, B: 0.5 mm anterio-posterior discrepancy on lateral view (interrupted line: CR, solid line: MICP).

Fig. 4.

Cephalometric radiograph.

Fig. 5.

Measurement of Freeway space. A: Vertical dimension at rest, B: Vertical dimension at occlusion.

Fig. 6.

Cephalometric radiograph analysis. A: ideal upper and left facial proportions suggested by Hull11; 43%, 67% each, B: actual upper and left facial proportions of patient; 46.7%, 53.3% each.

Fig. 7.

Abutment evaluation; crown to root ratio. A: 1:1 on right lower second premolar, B: 1:1.3 on right lower first premolar, 1:1.7 on right lower canine.

Fig. 8.

Diagnostic wax-up.

Fig. 9.

Provisional prosthesis. A: During right lateral movement, group function on balancing side. Right mandibular first molar, being a pontic, was excluded. B: Frontal view. C: During left lateral movement, canine guidance on balancing side.

Fig. 10.

Definitive prosthesis. Same occlusal pattern verified through provisional prosthesis was given.

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