Page 34 - DP Vol 20 No 5_Neat

COSMETIC SECTION

FULL MOUTH REHABILITATION TO

IMPROVE FUNCTION AND AESTHETICS

WITH LITHIUM DI SILICATE RESTORATIONS

Sanah Sayed

INTRODUCTION
Full mouth rehabilitation is a comprehensive dental treatment plan
designed to restore optimal oral health, function and aesthetics. It
addresses multiple dental issues simultaneously to improve overall
wellbeing.

WHY ARE THESE BECOMING ONE OF THE MAINSTAY
TREATMENT MODALITIES AT MY PRACTICE?
With increased life expectancy, lifestyle, and diet changes, as well
as stress, patients are retaining natural teeth but losing enamel and
experiencing tooth wear due to parafunction, cola consumption, or
systemic acidity. Missing tooth structure can result in the collapse Fig 1: Pre operative smile
of vertical dimension, making the face look more aged or sunken. It
can also affect bite, speech, and self-confidence. Some of these cases
report discomfort while chewing, jaw pain, joint issues, and muscle
soreness in the neck and temple regions.

CASE DISCUSSION
The case I am presenting today is that of a 60-year-old male patient
with a history of tobacco chewing leading to significant tooth wear.
He had discontinued the habit a year ago and was looking to improve
his functionality and aesthetics for his daughter’s wedding. Since he
resided in the United States, we were on a tight timeline and completed
the case in less than a month. This required longer appointments and Fig 2
addressing multiple units simultaneously.

INITIAL ASSESSMENT
A thorough examination of the teeth, gums, and jaw was done. A
customized plan was developed based on the patient’s needs and
goals. Some of the teeth required buildups on the buccal surfaces
to repair erosion, and the wisdom teeth were extracted. The patient
returned a couple of days later for preoperative photographs and
scans. A Lucia jig was used to deprogram the patient and record the Fig 3
centric relation (CR), ensuring restorative space and a free envelope
of function.

FUNCTIONAL DESIGN
This centric relation formed the basis of a functional design that acted
as a “test drive” for the patient before committing to the treatment. It
also provided the clinician with insights into what to expect and how
to approach the final preparation. This approach allows for visualizing
the goal and working backward in terms of tooth preparation, thereby Fig 4
saving enamel.
The laboratory used full-face retracted and non-retracted Fig 2-4: Retracted preoperative situation

34 Dental Practice I November-December 2024 I Vol 20 No 5