Interdisciplinary approach to the rehabilitation of patients with a need for complete dental reconstruction: a clinical case

Abstract

This study aimed to test the algorithm of complex clinical, functional, and instrumental analysis in the context of treatment for patients with a need of complete dental reconstruction.

Materials and methods. A rehabilitation program for patients with adentia was proposed, which was based on the objective examination data obtained comprehensively with multiple diagnostic methods. Particular attention was paid to the temporomandibular joint function and symptoms of maxillofacial muscle abnormalities.

Results. The clinical case report covers the results of the examination and treatment of a patient who previously received implants in one of the clinics without an appropriate examination and an operating template. A set of diagnostic and therapeutic procedures was defined that included clinical, functional, and instrumental analysis of condylographic and cephalometric data. The outcomes from treatment and rehabilitation allowed the optimal occlusal load distribution, and the oral hygiene improved. The approach that was used here enabled a timely correction of functional and esthetic disorders.

Conclusions. The algorithm to treat patients who need complete dental reconstruction should include asking the medical history, clinical instrumental analysis (condylography), recording and evaluating the static and dynamic occlusal characteristics, and assessing cephalometric and esthetic characteristics. The algorithm is anatomically and pathogenetically justified, since it takes into account all alterations and interconnections between dentofacial structures and other body systems that underlie the clinical manifestations in patients with adentia who have a need for complete dental reconstruction.

Keywords

dental orthopedic rehabilitation / condylography / temporomandibular joint / diagnostic wax-up / occlusion / aesthetic disorders

References

[1] Semenuk VM, Ahmetov EM, Fedorov VE, Kachura GP, Ahmetov SE. The results of the organization, the effectiveness of orthopedic treatment and quali-ty of dental prostheses (data from sociological research). Institut Stomatologii. 2017;(1):26–9. (in Russian)

[2] Семенюк В.М., Ахметов Е.М., Федоров В.Е., Качура Г.П., Ахметов С.Е. Результаты организации, эффективности ортопедического лечения и качества зубных протезов (данные социологического исследования). Институт стоматологии. 2017;(1): 26–9.

[3] Bulycheva EA. A differentiated approach to the development of pathogenetic therapy for patients with temporomandibular joint dysfunction complicated by masticatory hypertension. [dissertation abstract] St. Petersburg; 2010. 28 p. (in Russian)

[4] Булычева Е.А. Дифференцированный подход к разработке патогенетической терапии больных с дисфункцией височно-нижнечелюстного су-става, осложненной гипертонией жевательных мышц: Автореф. дис. … д-ра мед. наук. СПб.; 2010. 28 с.

[5] Rubnikovicha SP, Khomichb IS. Restoration of dental function and aesthetics of the patient utilizing surgical and prosthetic steps and digital technologies. Stomatolog. Minsk. 2018;(1):32–47. (in Russian)

[6] Рубникович С.П., Хомич И.С. Восстановление функции и эстетики зубочелюстной системы стоматологического пациента с применением хи-рургических и ортопедических методик и цифровых технологий. Стоматолог. Минск. 2018;(1):32–47.

[7] Lar'kina EA. The effectiveness of cooperation between the orthodontist and the orthopedic dentist in the treatment of complex pathology. Byulleten' med-itsinskikh internet-konferentsiy. 2014;4(4):346. (in Russian)

[8] Ларькина Е.А. Эффективность сотрудничества ортодонта и ортопеда-стоматолога в процессе лечения комплексной патологии. Бюллетень медицинских интернет-конференций. 2014;4(4):346.

[9] Dolce MC, Aghazadeh-Sanai N, Mohammed S, Fulmer TT. Integrating oral health into the interdisciplinary health sciences curriculum. Dent. Clin. North Am. 2014;58:829–43. Doi: 10.1016/j.cden.2014.07.002.

[10] Dolce M.C., Aghazadeh-Sanai N., Mohammed S., Fulmer T.T. Integrating oral health into the interdisciplinary health sciences curriculum. Dent. Clin. North Am. 2014;58:829–43. Doi: 10.1016/j.cden.2014.07.002.

[11] Chatzopoulos GS, Wolff LF. Symptoms of temporomandibular disorder, self-reported bruxism, and the risk of implant failure: a retrospective analysis. Cranio. 2020;38(1):50–7. Doi: 10.1080/08869634.2018.1491097.

[12] Chatzopoulos G.S., Wolff L.F. Symptoms of temporomandibular disorder, self-reported bruxism, and the risk of implant failure: a retrospective analysis. Cranio. 2020;38(1):50–7. Doi: 10.1080/08869634.2018.1491097.

[13] Grabkov YP, Gavrilov YA, Romankov IA. Aesthetic norm of dental restorations in coordinate system of facial symmetry. Experience aesthetic prosthetic teeth from concept to clinical introduction. Morfologicheskii al'manakh imeni V.G. Koveshnikova. 2019;17(2):94–102. (in Russian)

[14] Грабков Ю.П., Гаврилов В.А., Романьков И.А. Критерии эстетической нормы стоматологических реставраций в системе координат лицевой симметрии и наш опыт эстетического протезирования зубов. Морфологический альманах имени В.Г. Ковешникова. 2019;17(2):94–102.

[15] Budny'i AA, Plodistaya ID. Modern technologies in orthopedic dentistry. Byulleten' meditsinskikh internet-konferentsiy. 2018;8(7):288. (in Russian)

[16] Будный А.А., Плодистая И.Д. Современные технологии в ортопедической стоматологии. Бюллетень медицинских интернет-конференций. 2018;8(7):288.

[17] Chikunov SO, Trezubov VV, Buly`cheva EA, Alpat`eva YuV. Gentle prosthetics without prior preparation of abutment teeth. Institut stomatologii. 2012;(2):52–3. (in Russian)

[18] Чикунов С.О., Трезубов В.В., Булычева Е.А., Алпатьева Ю.В. Щадящий способ протезирования без предварительной подготовки опорных зу-бов. Институт стоматологии. 2012;(2): 52–3.

[19] Trezubov VN, Chikunov SO, Bulycheva EA, Alpat'eva JuV, Bulycheva DS. Step by step modeling of dentition in difficult clinical picture. Klinicheskaya stomatologiya. 2017;(3):60–3. (in Russian)

[20] Трезубов В.Н., Чикунов С.О., Булычева Е.А., Алпатьева Ю.В., Булычева Д.С. Поступательное моделирование зубных рядов при сложной клини-ческой картине. Клиническая стоматология. 2017;(3):60–3.

[21] Buly'cheva EA, Chikunov SO, Alpat`eva YuV. Development of a rehabilitation therapy system for patients with various clinical forms of diseases of the temporomandibular joint complicated by muscle hypertension (Part II). Institut stomatologii. 2013;(1):76–7. (in Russian)

[22] Булычева Е.А., Чикунов С.О., Алпатьева Ю.В. Разработка системы восстановительной терапии больных с различными клиническими формами заболеваний височно-нижнечелюстного сустава, осложненных мышечной гипертонией (часть II). Институт стоматологии. 2013;(1):76–7.

[23] Tosun H, Kaya B. Effect of maxillary incisors, lower lip, and gingival display relationship on smile attractiveness. Am. J. Orthod. Dentofacial. Orthop. 2020;157(3):340–7. Doi: 10.1016/j.ajodo.2019.04.030.

[24] Tosun H., Kaya B. Effect of maxillary incisors, lower lip, and gingival display relationship on smile attractiveness. Am. J. Orthod. Dentofacial. Orthop. 2020;157(3):340–7. Doi: 10.1016/j.ajodo.2019.04.030.

[25] Kalia R. An analysis of the aesthetic proportions of anterior maxillary teeth in a UK population. Br. Dent. J. 2020;228(6):449–55. Doi: 10.1038/s41415–020–1329–9.

[26] Souza M, Cavalheiro JP, Bussaneli DG, Jeremias F, Zuanon AC. Esthetic reconstruction of teeth with enamel hypoplasia. Gen. Dent. 2020;68(2):56–9.

[27] Souza M., Cavalheiro J.P., Bussaneli D.G., Jeremias F., Zuanon A.C. Esthetic reconstruction of teeth with enamel hypoplasia. Gen. Dent. 2020;68(2):56–9.

[28] Augusti D, Augusti G, Ionescu A, Brambilla E, Re D. Natural tooth pontic using recent adhesive technologies: an esthetic and minimally invasive pros-thetic solution. Case Rep. Dent. 2020;5:7619715. Doi: 10.1155/2020/7619715.

[29] Augusti D., Augusti G., Ionescu A., Brambilla E., Re D. Natural tooth pontic using recent adhesive technologies: an esthetic and minimally invasive prosthetic solution. Case Rep. Dent. 2020;5:7619715. Doi: 10.1155/2020/7619715.

[30] Gil-Martinez A, Paris-Alemany A, Lopez-de-Uralde-Villanueva I, La Touche R. Management of pain in patients with temporomandibular disorder (TMD): challenges and solutions. J. Pain Res. 2018;11:571–87. Doi: 10.2147/JPR.S127950.

[31] Gil-Martinez A., Paris-Alemany A., Lopez-de-Uralde-Villanueva I., La Touche R. Management of pain in patients with temporomandibular disorder (TMD): challenges and solutions. J. Pain Res. 2018;11:571–87. Doi: 10.2147/JPR.S127950.

[32] Saga AY, Araujo EA, Antelo OM, Meira TM, Tanaka OM. Nonsurgical treatment of skeletal maxillary protrusion with gummy smile using headgear for growth control, mini-implants as anchorage for maxillary incisor intrusion, and premolar extractions for incisor retraction. Am. J. Orthod. Dentofacial. Orthop. 2020;157(2):245–58. Doi: 10.1016/j.ajodo.2018.09.021.

[33] Saga A.Y., Araujo E.A., Antelo O.M., Meira T.M., Tanaka O.M. Nonsurgical treatment of skeletal maxillary protrusion with gummy smile using headgear for growth control, mini-implants as anchorage for maxillary incisor intrusion, and premolar extractions for incisor retraction. Am. J. Orthod. Dentofa-cial. Orthop. 2020;157(2):245–58. Doi: 10.1016/j.ajodo.2018.09.021.

[34] Utyuzh A. Yumashev A. Mikhailova M. Orthopedic titanium alloy constructions in intolerance of conventional dental prostheses. Vrach. 2016;(7):62–4. (in Russian)

[35] Утюж А., Юмашев А., Михайлова М. Ортопедические конструкции из сплавов титана при непереносимости традиционных зубных протезов. Врач. 2016;(7):62–4.

[36] Karthik KVGC, Padmaja BI, Babu NS, Haritha J, Nikhil M, Priya KS. Evaluation of esthetics of incisor position in relation to incisive papilla to replicate in the denture prosthesis. J. Family Med. Prim. Care. 2020;9(1):298–302. Doi: 10.4103/jfmpc.jfmpc_772_19.

[37] Karthik K.V., Padmaja B.I., Babu N.S., Haritha J., Nikhil M., Priya K.S. Evaluation of esthetics of incisor position in relation to incisive papilla to replicate in the denture prosthesis. J. Family Med. Prim. Care. 2020;9(1):298–302. Doi: 10.4103/jfmpc.jfmpc_772_19.

[38] Revilla-Leon M, Campbell HE, Meyer MJ, Umorin M, Sones A, Zandinejad A. Esthetic dental perception comparisons between 2D- and 3D-simulated dental discrepancies. J. Prosthet. Dent. 2020; S0022–3913(19)30752–8. Doi: 10.1016/j.prosdent.2019.11.015.

[39] Revilla-Leon M., Campbell H.E., Meyer M.J., Umorin M., Sones A., Zandinejad A. Esthetic dental perception comparisons between 2D- and 3D-simulated dental discrepancies. J. Prosthet. Dent. 2020; S0022–3913(19)30752–8. Doi: 10.1016/j.prosdent.2019.11.015.

RIGHTS & PERMISSIONS

Eco-Vector