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