Patel, Purvi, Tran, Brandon
University of Pennsylvania School of Dental Medicine, Department of Preventive and Restorative Sciences
Full mouth rehabilitation or reconstruction (FMR) involves rebuilding or replacing all of the teeth in a patient’s mouth. This treatment serves to combine esthetics and restorative dentistry with the purpose of optimizing the health of the entire mouth including the teeth, gums and occlusion (American College of Prosthodontics, 2021). FMR is often indicated in patients with severe bruxism, dental trauma, periodontal disease or chronic pain stemming from temporomandibular disorder. Our case study subject suffers from a history of dental trauma, bruxism and chronic pain making them an ideal candidate for full mouth rehabilitation.
MethodsA comprehensive treatment plan was created in the Vulnerable Populations Clinic including a six unit fixed dental prosthesis spanning from tooth #5 to 11, a single crown on tooth #12, a partial removable dental prosthesis to replace tooth #3-4 & #13-14, as well as an implant retained complete removable dental prosthesis to replace the mandibular teeth from #19-30. Caries removal was completed on all restorable teeth present in the patient’s mouth and all non-restorable teeth were extracted. Alveoloplasty of the mandibular right and left alveolar ridges was completed.
ResultsThe results of the full mouth rehabilitation are still pending, but currently extensive oral surgery, orthodontic, restorative and prosthodontic work have been completed. Full arch extractions on the mandibular along with alveoloplasty were done in oral surgery. Orthodontic work was completed using a removable hawley appliance with rubber bands in order to retract the patient’s maxillary anterior teeth into alignment for fabrication of a maxillary splint. The patient had a severe loss of VDO due to missing teeth, a deep bite and years of bruxism. A provisional complete denture was fabricated to restore the patient's bite as well as provide function while the implants are being placed.The fixed dental prosthesis on the maxilla as well as the removable partial denture on the maxilla are still being fabricated so more results are pending.
ConclusionWorking with patients in a vulnerable population often changes the way treatment can be executed. The patient's chief complaint was that she wanted to keep her maxillary anterior teeth at all cost. Thus, this complex treatment plan was created in order to work around the constraints of the patient’s concerns as well as what would be functionally and aesthetically best.