Full Mouth Rehabilitation Part-I: Presented by DR - Priyadarshini PG Iiiyr
Full Mouth Rehabilitation Part-I: Presented by DR - Priyadarshini PG Iiiyr
Full Mouth Rehabilitation Part-I: Presented by DR - Priyadarshini PG Iiiyr
PART-I
P R E S ENTED B Y
D R . P R I YADAR SHINI
PG IIIYR
Introduction
STOMATOGNATHIC SYSTEM
TMJ
MUSCLES
TEETH AND
SUPPORTING
STRUCTURES
BIOLOGIC ADAPTATION
Stomatognathic
system
• Stress/strain
Adaptation to the
environment • If the strain exceeds
adaptive capacity
Damage or • It has to be
disturbance to the restore to normal
system level
WHAT IS FULL MOUTH REHABILITATION
• Full mouth rehabilitation entails the performance of all the procedures
necessary to produce healthy, esthetic, well functioning and self
maintaining masticatory mechanism
- GPT 8
- GPT 8
WHEN FMR
severly attrited , eroded teeth and in conditions
which will cause pain and discomfort of teeth and
surrounding structures.
Restoration of multiple teeth which are broken,
missing or decayed.
To restore impaired occlusal function
Developmental anomalies , discoloured teeth
WHEN NOT TO.....
• Friends and relatives of one's rehabilitation
• patients will request similar treatment.
• NO PATHOLOGY- NO TREATMENT
GOALS OF ANY DENTAL TREATMENT
ANATOMIC
HARMONY
OPTIMAL FUNCTIONAL
ESTHETICS
ORAL HEALTH HARMONY
OCCLUSAL
STABILITY
OBJECTIVES OF FULL MOUTH
REHABILITATION
Occlusal stability
Anterior guidance
Disclusion of
posterior teeth
Axial loading of
teeth
HOW TO DETERMINE IF THE TMJS ARE HEALTHY
Range and path of movement tests
Doppler analysis
Load test
Temporalis muscle
Inferior lateral pterygoid muscle. Superior lateral pterygoid muscle.
Hyoid area
• Sternocleidomastoid (SCM) muscle
• Occipital area
• Trapezius muscle
Eruptive Force Vs Tooth Wear
• Throughout life, eruptive force causes teeth to move
vertically with their alveolar bone
• Stopping force:
• Teeth of opp arch
• Tongue..Thumb …Lips
• Objects…. Pipes/ appliances
Diagnostic:
oNon Diagnostic Dependably related to tooth surfaces that are
in direct interference with functional / para
functional movements of mandible
TOOTH WEAR
• Attrition
• Normal Process
• Excessive occlusal wear Intracapsular disorder
• Pulpal pathology Decreased ramus ht. puts the
• Impaired function molars into interference
• Occlusal disharmony Posterior tooth Wear:
• Esthetic disfigurement Interference with completely
seated TMJ / anterior guidance
Worn surfaces can be contacted
during centric relation closure /
during excursions to and from CR
• Abrasion of teeth
• Diet & chewing of abrasives (tobacco)
• Environmental Factors
• Dust & grit
• Unglazed porcelain restorations
Erosion
Chemical action
Citrus juices…Cold drinks… Vinegar…Pickled foods
Constant Regurgitation/ Projectile vomiting (GERD)
Loss of Posterior Support
Attrition of Ant. teeth ….
Loss of posterior teeth
Malposition of teeth
Occlusal interference…. Drives mandible forward
Tooth Wear
• Congenital Anomalies
• Amelogenesis Imperfecta
• Hypoplastic … . 1/8 – ¼ enamel
thickness
• Hypomaturation … . .softer enamel
• Hypocalcified … . friable enamel
• Dentinogenesis Imperfecta
• Weak enamel attachment
• Rapid Attrition
Tooth Wear
Group function
• CR & IP coincident
Krishna MG, Rao KS, Goyal K, Prosthodontic management of severely worn dentition:
including review of literature related to physiology and pathology of increased vertical
dimension of occlusion. J Prosthet Dent 2005 ; 5(2): 89-93