Interdisciplinary approach on oral rehabilitation of an adolescent patient with multiple missing teeth: a clinical report

Kung-Rock Kwon; Janghyun Paek; Hyun-Woo Kim

doi:10.4047/jkap.2013.51.4.339

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Kwon, Paek, and Kim: Interdisciplinary approach on oral rehabilitation of an adolescent patient with multiple missing teeth: a clinical report

Case Report

J Korean Acad Prosthodont 2013;51(4):339-346.

Published online: NaN October 2013

DOI: https://doi.org/10.4047/jkap.2013.51.4.339

Interdisciplinary approach on oral rehabilitation of an adolescent patient with multiple missing teeth: a clinical report

Kung-Rock Kwon, DMD, MSD, PhD^∗, Janghyun Paek, DMD, MS, PhD, Hyun-Woo Kim

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

∗Corresponding Author: Kung-Rock Kwon Department of Prosthodontics, School of Dentistry, Kyung Hee University, Hoegi-dong 1, Dongdaemun-Gu, Seoul, 130-701, Korea +82 2 958 9340; e-mail, krkwon@khu.ac.kr

Received 20 August 20135 September 2013 Accepted 30 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

In case of missing of permanent teeth by trauma or innate defect, the decision of treatment modalities and application timing have an important effect on the prognosis of oral rehabilitation. In this case report, interdisciplinary approach between the orthodontic and prosthodontic treatment, the way to re-establish the collapsed occlusal vertical dimension, and implant prosthetic considerations will be discussed. Proper diagnosis on teeth and craniofacial skeleton was made prior to treatment and provisional restorations were used in regard of growth patterns of the patient. Finally, the edentulous areas were restored with fixed implant prostheses. Diagnosis, treatment rationale and prognosis will be discussed thoroughly. (J Korean Acad Prosthodont 2013;51:339-46)

Keywords: Congenital missing, Oligodontia, Occlusal vertical dimension, Growth and development

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Fig. 1.

Pre-operative panoramic radiograph (January 1999).

Fig. 2.

Pre-operative intraoral photographs (March 1999).

Fig. 3.

Diagnostic wax-up with proper crown contour and ratio.

Fig. 4.

Maximum intercuspation with provisional restoration.

Fig. 5.

Panoramic radiograph after endodontic treatment on maxillary anterior teeth and bone graft on mandibular defect area.

Fig. 6.

Occlusal plane establishment (with KaVo occlusal plane plate).

Fig. 7.

Intraoral photographs of final prosthesis.

Fig. 8.

Panoramic radiograph of final prosthesis.

Fig. 9.

Facial profile with final prosthesis.

Fig. 10.

Panoramic radiograph with RSM (January 1995) and root resorption of first molar by erupting first premolar (January 1999).

Fig. 11.

Occlusal plane establishment considering clinical crown length of maxillary and mandibular central incisor, vertical and horizontal overlap, height of first molar and height of retromolar pad.

Fig. 12.

Direction of implantation should be parallel to the long axis of opposing teeth.

Table 1.

Diagnosis and treatment objectives

Diagnosis	Skeletal Class 1, Spacings, Microdontia, Oligodontia
Tx. Objectives	Upper	1. Correction of rotated teeth (#16, #26) 2. Space adjustment for fixed partial denture. (pontic #12, #15, #25)
	Lower	1. Eruption guidance (#44) 2. Space adjustment for prosthesis

Table 2.

Clinical tooth diameter and length (unit; mm)

	Upper			Lower
	Central incisor	Lateral incisor	Canine	Central incisor	Lateral incisor	Canine
Crown length	10.3 - 10.4	8.5 - 8.7	9.6 - 9.9	8.3 - 8.5	8.7	10.0 - 10.6
Crown width	8.5 - 8.3	7.2 - 7.0	8.3	5.4 - 5.6	6.0 - 6.1	7.4

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