Mandibular Region Research Articles

Clinical Evaluation of Stability of Short Deep Threaded Dental Implant During Early Healing Period: A Prospective Controlled Clinical Trial

Objectives: To assess the initial stability of short, deep-threaded dental implants placed in the posterior mandible and to determine the influence of deep-thread design on implant stability during early healing. Methods: Twenty short, deep-threaded implants were placed in the posterior mandibular region of ten patients. Insertion torque value (ITV) was recorded at implant placement. Implant stability quotient (ISQ) was measured immediately post-surgery and at weeks 2, 3, 4, and 5. Results: No significant difference in ITV was observed between short and standard implants. ISQ values did not significantly differ between implant types across the evaluation period (F = 1.17, p = 0.3). Conclusion; Short, deep-threaded implants demonstrate comparable primary stability to standard implants in the posterior mandible. These findings support their use as a viable treatment option for patients with advanced alveolar ridge resorption

Enhancing sports mouthguards with PLA + and PC: stress reduction, energy absorption, and topology optimization.

The objective of this paper was to compare the effectiveness of different materials for mouthguards in preventing oral and maxillofacial injuries during sports activities. The present study compares the stress-reduction and energy absorption capabilities of two other fused filament materials - poly(lactic-acid plus) (PLA+) and polycarbonate (PC), with Ethylene-vinyl acetate (EVA), which is the most commonly used material for mouthguard fabrication. Two human skulls were modelled, and a boxing glove simulated punches along the x, y, and z-axes with 5mm displacement with 1 kN force. Firstly, the maximum principal stress curve in the skull was compared for forces along the three perpendicular directions. Furthermore, the present study examines materials energy absorption properties, including their specific energy absorption characteristics and initial peak von Mises stresses. Additionally, a topology optimization approach is used to create an alternative design for a mouthguard to improve specific energy absorption. The model without a mouthguard showed the highest stress concentration of 32.298MPa in the teeth, followed by the EVA material, which resulted in a maximum principal stress of 28.525MPa. Fused filament 3D materials, such as PLA + and PC, on the other hand, showed better mechanical effectiveness in both lower jaw dislocation and lower maximum principal stress by 30.82% and 51.25% in the mandibular and maxillary teeth. Though EVA comparatively shows better specific energy absorption capability at 2.24kJ/kg post-optimization than PLA + and PC, the peak principal stress experienced in the mandibular region was comparatively higher. The topology optimization, however, improved the energy-absorbing capabilities of PLA + by 4.5 times, reaching 1.37kJ/kg and PC from 0.165kJ/kg to 0.38kJ/kg. This study demonstrates that PLA + and PC have better stress reduction capabilities than EVA and could be promising materials for the fabrication of mouthguards in sports activities. This study highlights the importance of topology optimization in dental materials science and engineering to develop safer and more effective mouthguard designs.

Simple bone cyst of the mandible: A case report with review of literature

Simple bone cyst (SBC) was first described by Lucas in 1929. It is an asymptomatic, intraosseous cyst. It falls under pseudocyst category, as it is devoid of an epithelial lining and mostly discovered accidently on routine radiograph. It commonly affects metaphyses of long bones such as humerus and femur. Other terminologies used for this lesion include Solitary bone cyst, traumatic bone cyst and hemorrhagic bone cyst. The incidence of cyst affecting the jaws is only 1%. About 89% of the lesion occurs in mandible and 11% in maxilla. The purpose of this article is to present rare occurrence of SBC in the mandibular region with review of literature. An 18 year old male patient reported with pain in right lower back teeth region. Clinically 47 was tender. Panoramic radiograph showed a radiolucent unilocular lesion in ascending ramus and mandibular body distal to 47. Diagnosis of apical periodontitis in relation to 47 and simple bone cyst mandible was made by correlating clinical, radiographic and histopathological evaluation. Surgical curettage was performed and follow up after 4 months revealed no evidence of recurrence. Simple bone cyst is rare incidental lesion of the mandible. Thorough clinical, radiological and histopathologic evaluation is helpful for diagnosis and surgical management of the lesion. Conservative management should be approached to prevent noble structure, with follow up to confirm remission of the lesion.

A Contemporary Approach: Presentation of 4 Cases with the Entire Papilla Preservation (EPP) Technique

Regeneration of periodontal tissue is a primary goal of periodontal treatment. Periodontal regeneration approaches are widely used in the treatment of intraosseous defects. However, the success of these techniques depends on many factors, including surgical considerations. Failures in wound closure in the interdental region, which are surgical factors, have led to the development of papilla preservation techniques. The entire papilla preservation technique (EPP) maintains the integrity of the papilla associated with the defect. This technique stabilizes the blood clot with intact gingiva, preventing wound exposure and contamination. EPP is performed in intra-osseous defects through a short buccal vertical incision, without incising the papilla of the involved tooth. A full-thickness buccal flap is lifted from the incision to the relevant papilla and a tunnel extending under the papilla is prepared. The papilla is also lifted to full thickness. The defect is cleaned of granulation tissue and the wound is closed primarily with or without biomaterial application. In this report, we present 4 cases, 3 in the anterior maxilla and 1 in the mandibular premolar region, undergoing periodontal surgery with EPP with biomaterial application with a 3-month follow-up. In all cases, soft tissue healing was uncomplicated and radiographs showed bone filling at 3 months. EPP has a high success rate in periodontal regeneration by providing complete nutrition of the interdental papilla through natural, continuous vascular support in intraosseous defects.

Distraction osteogenesis application in bone defect caused by osteomyelitis following mandibular fracture surgery: a case report and literature review

BackgroundOsteomyelitis secondary to mandibular fracture surgery is rare and complete surgical debridement of necrotic infected tissues is an optimal treatment for it. Subsequent reconstruction is required for bone defect caused by operation. Autogenous, allograft and synthetic bone graft substitutes have become widespread in bone defect treatment. Distraction osteogenesis (DO) was also applied in bone defect reconstruction, even it wasn’t conventional therapy in jaw.Case presentationHere we report a case of a 40-year-old aged man who presented with chronic swelling and pain on the right mandibular masseteric region after mandibular angle and Le Fort II fracture surgery. In six weeks after surgery, CBCT images showed that the fracture ends hadn’t heal and the fracture gap had widened significantly. The clinical diagnosis of the patient was right mandibular angle osteomyelitis. After controlling the symptoms of pain and infection with local rinses and systemic antibiotic therapy, the patient underwent segmental resection of the infected bone and DO reconstruction for bone defect simultaneously. Encouragingly, well bone healing and normal occlusion restoration was observed finally.ConclusionsDO could be a valuable alternative therapy to bone grafts for bone defect, even in the case of infection.

Biomechanical Evaluation of Hydroxyapatite/poly-l-lactide Fixation in Mandibular Body Reconstruction with Fibula Free Flap: A Finite Element Analysis Incorporating Material Properties and Masticatory Function Evaluation.

In reconstructive surgery following partial mandibulectomy, the biomechanical integrity of the fibula free flap applied to the remaining mandibular region directly influences the prognosis of the surgery. The purpose of this study is to evaluate the biomechanical integrity of two fixation materials [titanium (Ti) and hydroxyapatite/poly-L-lactide (HA-PLLA)]. In this study, we simulated the mechanical properties of miniplate and screw fixations in two different systems by finite element analysis. A three-dimensional mandibular model was constructed and a fibula free flap and reconstruction surface were designed. The anterior and posterior end of the free flap was positioned with two miniplates and two additional miniplates were applied to the angled area of the fibula. The masticatory loading was applied considering seven principal muscles. The peak von Mises stress (PVMS) distribution, size of fixation deformation, principal stresses on bones, and gap opening size were measured to evaluate the material properties of the fixation. In the evaluation of properties, superior results were observed with both fixation methods immediately after surgery. However, after the formation of callus between bone segments at 2 months, the performance of Ti fixation decreased over time and the differences between the two fixations became minimal by 6 months after surgery. The result of the study implies the positive clinical potential of the HA-PLLA fixation system applied in fibula free flap reconstruction.

Strategies for prevention and treatment of vascular and nerve injuries in mandibular anterior implant surgery

Important anatomical structures such as mandibular incisive canal, tongue foramen, and mouth floor vessels may be damaged during implant surgery in the mandibular anterior region, which may lead to mouth floor hematoma, asphyxia, pain, paresthesia and other symptoms. In severe cases, this can be life-threatening. The insufficient alveolar bone space and the anatomical variation of blood vessels and nerves in the mandibular anterior region increase the risk of blood vessel and nerve injury during implant surgery. In case of vascular injury, airway control and hemostasis should be performed, and in case of nerve injury, implant removal and early medical treatment should be performed. To avoid vascular and nerve injury during implant surgery in the mandibular anterior region, it is necessary to be familiar with the anatomical structure, take cone-beam computed tomography, design properly before surgery, and use digital technology during surgery to achieve accurate implant placement. This article summarizes the anatomical structure of the mandibular anterior region, discusses the prevention strategies of vascular and nerve injuries in this region, and discusses the treatment methods after the occurrence of vascular and nerve injuries, to provide clinical reference.

Assessment of biomechanical strength of titanium versus unsintered-hydroxyapatite/poly-L-lactic acid (u-HA/PLLA) osteosynthesis screws in bilateral sagittal split ramus osteotomy

Titanium osteosynthesis is considered to be stable for the bilateral sagittal split ramus osteotomy (BSSRO) procedure in orthognathic surgery but is disregarded owing to a multitude of complications, the most significant necessitating a secondary surgery for removal. Bioresorbable osteofixation devices, especially third-generation unsintered-hydroxyapatite/poly-L-lactic acid (u-HA/PLLA), are increasingly used in the mandibular region because of their strength and bioactive/osteoconductivity. To date, three titanium bicortical screws has been the standard for the rigid fixation of BSSRO. As data on the use of u-HA/PLLA bicortical screws are limited, we conducted an in vitro biomechanical strength test to evaluate the performance of 12-mm bicortical u-HA/PLLA screws in comparison with titanium screws using mandibular bone models. BSSRO was performed on all specimens, followed by fixation with either three titanium screws or three, four, or five u-HA/PLLA screws, and loading was performed using a clinically presumed occlusal force. Displacement forces (measured in newton ‘N’) of 50N, 130N, and 220N were applied. Our results showed that the use of three u-HA/PLLA screws was unstable, that of four u-HA/PLLA screws was comparable, and that of five u-HA/PLLA screws provided stability equal to that of the three titanium bicortical screws. Although further clinical assessment is needed, our study demonstrated that the five u-HA/PLLA bicortical screws are viable alternatives to titanium in BSSRO osteofixation.

Mesiodistal tip expression of mandibular anterior teeth in patients with mandibular incisor extraction treated with Invisalign aligners

Extraction of a single mandibular incisor may be prescribed in conjunction with clear aligner orthodontic treatment. The accuracy of therapeutic mesiodistal tooth positioning for the remaining mandibular anterior teeth for such patients has not been comprehensively evaluated. This retrospective study compared the predicted and achieved mesiodistal tooth movements in the mandibular anterior region for patients treated with Invisalign (Align Technology, Santa Clara, Calif), along with the influence of aligner attachments and the frequency of aligner change. A sample of 83 subjects who had undergone Invisalign treatment with a single mandibular incisor extraction was collected from an existing database. The pretreatment tooth positions, the predicted mesiodistal tooth movement, and the achieved outcomes were measured for the remaining mandibular anterior teeth using Geomagic Control X metrology software (3D Systems, Rock Hill, SC). The predicted and achieved mesiodistal tip movements were analyzed and compared. Regression analysis revealed significant differences (P<0.001) between the predicted and achieved mesiodistal tooth positioning for incisors and canines. For every degree of predicted incisor mesiodistal tip, 78.89% of this tip was achieved (R2= 0.4901). For every degree of predicted canine tip, 54.16% was clinically expressed (R2= 0.5965). The accuracy of mesiodistal tip expression was not significantly affected by the prescribed number of aligners, 1-week vs 2-week aligner change protocols, or the presence of attachments (P>0.05). In addition, incisors were less likely to express the correct direction of the mesiodistal tip predicted than canines (P= 0.020). A shortfall between the predicted and clinically achieved expression of mesiodistal tooth movement with Invisalign was found for the anterior teeth after a mandibular incisor extraction. The number of aligners, duration of aligner wear, and specific attachment designs were not found to significantly influence the accuracy of the achieved mesiodistal tip movements.

Stress distribution by parafunctional loading on tooth–implant, implant–implant, and tooth–tooth-supported prosthesis: A comparative three-dimensional finite element analysis

Aim: The study’s objective was to evaluate the stress distribution in tooth-implant, implant-implant, and tooth-tooth supported prostheses under parafunctional loading in axial and oblique directions employing a 3D finite element analysis in the mandibular posterior region which had D3 bone (porous cortical bone and fine trabecular bone). Setting and Design: In vitro study, Finite element analysis. Meterials and Methods: Cone-beam computed tomography data was used by Mimics software (Materialize Mimics 19) to create a three-dimensional finite element simulation of the jaw. Solid Works 2018 (Dassault Systems) was used to produce a geometric 3D model of the three systems. Each model consisted of a bone, an implant, and teeth (Model I tooth-tooth supported, Model II tooth-implant supported and Model III implant-implant supported). The three models’ geometrical models were transferred to Ansys Workbench (19.2 software) for the analysis portion. A load that mimicked masticatory force was delivered in both axial and oblique directions. Statistical Analysis Used: In the present study, statistical analysis was not required because 3D finite element analysis uses deterministic numerical methods to simulate physical behavior and stress distribution patterns. Result: The results demonstrated that under the parafunctional combined loading process, the implant- implant supported prosthesis showed significantly higher stress concentrations in the bone. It was found that the cortical bone around the crestal region had the highest stresses. Conclusion: Within the constraints of this investigation, we could draw the following conclusion: Of the three models, the tooth-tooth supported prosthesis exhibited the least amount of stress distribution, which was also least when functional loading was applied in the axial direction.

Three-dimensional assessment of alveolar bone changes and root resorption in extraction patients after fixed orthodontic treatment: A prospective study

The aim of this study was to evaluate the alveolar crestal bone height, alveolar bone thickness, and root resorption in mandibular incisors after fixed orthodontic treatment. A total of 35 patients (mean age 17.02 ± 3.24 years) with moderate to severe mandibular anterior crowding requiring first premolar extraction were included. Cone beam computed tomography scans of the mandibular anterior region were obtained from the patients before and after orthodontic treatment. The alveolar crestal bone height, cortical bone thickness (CBT) (at apex and midroot level), labial and lingual alveolar bone thickness, and root resorption were assessed for all mandibular incisors. Paired Student's t test was used to compare pretreatment and post-treatment alveolar bone changes and root resorption. A significant decrease in lingual crestal bone height was observed in all mandibular incisors after orthodontic treatment (P < 0.001). Lingual CBT decreased at the midroot level significantly for all mandibular incisors after completion of orthodontic treatment (P < 0.001). A significant decrease in total lingual bone thickness was observed in all mandibular incisors (P < 0.001). Root lengths of mandibular incisors decreased significantly in the sagittal and coronal sections after orthodontic treatment (P < 0.001). Fixed orthodontic treatment with premolar extraction results in a significant reduction of alveolar crestal bone height, CBT (at midroot level), and alveolar bone thickness on the lingual aspect of mandibular incisors. Significant orthodontically induced inflammatory root resorption was observed in all mandibular incisors after orthodontic treatment.

Management Of Radicular Cyst Of Mandible In Pediatric Patients: A Case Series

Radicular cyst is a pathologic cavity partially or completely lined by epithelium in an area of apical periodontitis that is the result of root canal infection of a tooth. The radicular cysts are most likely caused by the inflammatory proliferation of Malassez's epithelial cell resting in the periapical tissues that are irritated. It rarely occurs in conjunction with deciduous teeth and is typically linked to permanent dentition. This article describes a case series of two male children, ages five and seven, who had an apical periodontal cyst in the mandibular posterior region of the jaw, which was connected to their deciduous teeth. Conservative treatment might have been the outcome of an early diagnosis of the lesion. The goal of this paper is to highlight the pedodontist's contribution in the early analysis of such lesions

The Associations of Adherent Gingival Thickness in the Buccal and Palatal Regions of the Maxilla and Mandibula with Age and Gender

Purpose: This study aimed to investigate gingival thickness variations regarding age, gender, and sites where mini-screws are frequently applied and to guide mini-screw size selection. Materials and Methods: In our study, gingival thickness measurements were performed by a transgingival probing method in 224 patients who presented for examination to the Department of Orthodontics, Faculty of Dentistry, XXXX University. Fifty-six females and 56 males aged 14-20 and 21-27 years were enrolled in the study. In each individual, measurements were made from the mucogingival junction at the interdental area in the buccal mandibular and buccal maxillary regions, whereas at the interdental area within 4 mm and 8 mm distance from the gingival crest in the palatinal maxilla. Results: Comparisons between genders indicated that gingival thickness in the buccal region of the maxilla was statistically significantly greater in males than in females (p

Fractal Dimension and Lacunarity Analysis in the Dentulous and Edentulous Mandibular Posterior Region Using Cone-beam Computed Tomography: A Cross-sectional Retrospective Study.

This cross-sectional retrospective study was conducted to assess the differences in the microarchitecture of the trabecular bone of the posterior mandibular region at dentulous and edentulous sites with the help of fractal dimension (FD) and lacunarity using cone-beam computed tomography (CBCT). Ninety CBCT scans were analyzed for the purpose of the present study. Inclusion criteria included subjects with unilaterally missing mandibular molars or premolars and an with intact contralateral opposing tooth. The coronal view of the dentulous and edentulous sites was used, and the region of interest (ROI) was selected 2.6 mm below the apex of the tooth present. These images were then transferred to ImageJ Software, and fractal analysis was done using the box-counting method of the FracLac plug-in. A paired samples t-test was performed to compare the means of FD and lacunarity, and a Kendall correlation was performed to check correlations. A p-value less than 0.05 was considered to indicate statistical significance. Statistical analysis revealed that the mean FD of the edentulous side was significantly greater than that of the dentulous side (p-value = 0.011). Additionally, the mean lacunarity of the edentulous side was marginally significantly greater than that of the dentulous side (p-value = 0.089). A significant negative correlation was detected between the FD and lacunarity of the edentulous region (p-value = 0.017), and a marginally significant negative correlation was detected between edentulous lacunarity and dentulous lacunarity (p-value = 0.081). The differences in occlusal forces exerted in dentulous and edentulous regions can lead to a change in the trabecular pattern of the bone in these regions. This change in the microarchitecture of bones can be detected by FD and lacunarity, which can further help us assess changes pre- and post-implant. The advanced technology, the assessment of microarchitecture of the bone has been made easy, using FD and lacunarity, as done in the present study. This analysis can further aid us in both pre- and post-implant analysis to prevent failure of the implant. How to cite this article: Bhoraskar M, Denny C, Srikant N, et al. Fractal Dimension and Lacunarity Analysis in the Dentulous and Edentulous Mandibular Posterior Region Using Cone-beam Computed Tomography: A Cross-sectional Retrospective Study. J Contemp Dent Pract 2024;25(6):581-587.

Ossifying fibromyxoid tumour in mandibular region: A case report

Ossifying fibromyxoid tumour in mandibular region: A case report

Assessment of anterior loop of mental foramen with cone beam computed tomography-An institutional based study

Cone beam computed tomography (CBCT) is a specialized imaging technology designed to create accurate 3D images of craniofacial anatomy while using significantly less radiation than traditional CT scans. This advancement allows clinicians to closely examine dental and maxillofacial structures, forensic analysis, and modern therapeutic techniques.To evaluate several anatomical variants of the anterior loop of the mental foramen using cone-beam computed tomography (CBCT).The study involved 30 randomly selected patients aged 20-60 year from the departmental OPD, who underwent CBCT of the anterior mandibular region to assess the mental foramen. After obtaining a detailed history, a diagnosis was made and explained to the patients. Data were analyzed according to the classification by Solar et al. (1994).Type 1 mental nerve loop presence was 6.6% greater on the right side (13.3%) than on the left side (6.7%), while Type 3 mental nerve loop presence was 6.6% higher on the left side (63.3%) than on the right side (56.7%) based on a comparison of the anterior loop of the mental foramen.However, Type 2 was similar on both the right (30.0%) and the left (30.0%) sides. The anterior loop of the mental foramen is an important anatomical feature and was comparable (Type 1/Type 2/Type 3) in patients on the right and left side (p &amp;#62; 0.05) (χ2=0.78, p = 0.678), showing no significant difference. Understanding its anatomy and occurrence has a significant impact on therapeutic strategies.

Relations between bone density from computed tomography and bone regeneration after reduction mandibuloplasty

BackgroundBone regeneration in the mandibular angle region after reduction mandibuloplasty may compromise the aesthetics of the lower face and thus lead to revision surgery. Bone quality is known to play an important role in osteogenesis. However, no study has evaluated the relationship between mandibular bone quality and bone regeneration volume. MethodsThe bone density of the mandibular angle immediately after surgery (BD) was determined as the grey level in computed tomography (CT) images. Based on the immediate postoperative and long-term follow-up CT images, the volumes of the regenerated angle (VSA) and the regenerated outer cortex (VOC) were measured after model reconstruction, automatic alignment and Boolean operation. Correlation analyses were then performed between VSA and BD, VOC and BD. Results23 patients (46 mandibular angles) were included in this study. The average BD was 907.09 ± 111.89 HU. The mean VSA was 201.66 (131.73–357.24) mm3. Spearman correlation analysis revealed a positive correlation between BD and VSA (r = 0.5449, p < 0.0001). The mean VOC was 236.23 ± 151.35 mm3. Pearson correlation analysis found a negative correlation between BD and VOC (r = -0.3501, p = 0.0171). ConclusionsCT images can provide a quantitative assessment of mandibular bone quality. BD may influence the volumes of bone regeneration in different areas of the mandibular angle portion after reduction mandibuloplasty, in the regenerated angle area positively and in the regenerated outer cortex region negatively. Therefore, slight over-grinding may be a choice to prevent secondary angulation.

Management Of A Completely Edentulous Hemimandibulectomy Patient With Maxillary Twin Occlusion And Mandibular Hollow Denture Prosthesis- A Case Report

The occurrence of Squamous Cell Carcinoma is high in patients with a history of long term tobacco use. Extensive lesions of the oral cavity may lead to resection of mandible, which can compromise the patient’s functions and esthetics to varying degrees, due to its complex attachments and prominent position in the facial architecture. Prosthodontic rehabilitation of a completely edentulous hemimandibulectomy patient is even more challenging due to a number of compromising factors. Revamping certain basic principles of Prosthodontics maybe necessary for successful rehabilitation of these patients. The ultimate aim of the Prosthodontist is to improve the quality of life of these patients, which will not only have a positive physical impact but also enhance the overall mental well being of these patients. This case report presents such a complex scenario of prosthodontic rehabilitation of a completely edentulous hemimandibulectomy patient. Due to the mandibular deviation towards the resected side, incorporation of a maxillary twin occlusion on the unresected side was required to attain a favourable post operative maxillomandibular relation. Due to the extension of the mandibular denture into the defect area in the mandibular region, considerable increase in weight of the mandibular denture was expected, which would have compounded the already existing compromised retention and stability owing to the decreased mandibular denture bearing area. Hence a hollow mandibular denture was planned to reduce the weight of mandibular dentures. Considerable improvement in esthetics and function were noticed and the patient is comfortable and well tolerated with the present prosthesis

A preliminary study of the mechanical properties of 3D-printed personalized mesh titanium alloy prostheses and repair of hemi-mandibular defect in dogs.

This study is a preliminary investigation exploring the mechanical properties of three-dimensional (3D)-printed personalized mesh titanium alloy prostheses and the feasibility of repairing hemi-mandibular defects. The ANSYS 14.0 software and selective laser melting (SLM) were used to produce personalized mesh titanium alloy scaffolds. Scaffolds printed using different parameters underwent fatigue property tests and scanning electron microscopy (SEM) of the fracture points. Models of hemi-mandibular defects (encompassing the temporomandibular joint) were created using beagle dogs. Freeze-dried allogeneic mandibles or 3D-printed personalized mesh titanium alloy prostheses were used for repair. Gross observation, computed tomography (CT), SEM, and histological examinations were used to compare the two repair methods. The prostheses with filament diameters of 0.5 and 0.7 mm could withstand 14,000 times and >600,000 cycles of alternating stresses, respectively. The truss-structure scaffold with a large aperture and large aperture ratio could withstand roughly 250,000 cycles of alternating forces. The allogeneic mandible graft required intraoperative shaping, while the 3D-printed mesh titanium alloy prostheses were personalized and did not require intraoperative shaping. The articular disc on the non-operated sides experienced degenerative changes. No liver and kidney toxicity was observed in the two groups of animals. The 3D-printed mesh titanium alloy prostheses could effectively restore the shape of the mandibular defect region and reconstruct the temporomandibular joint.

Full mouth rehabilitation of a patient with Restorative Space Issues and loss of VDO by replacing maxillary arch with fixed prosthesis opposing a flexible removable partial denture in mandibular arch: A case report

Primary objective of full mouth rehabilitation is the restoring the teeth to optimal physiological and functional balance . Planning a comprehensive course of treatment for a number of missing teeth can be difficult, particularly when the vertical dimension (VD) of the occlusion is reduced. In this case report the sequential methodical interdisciplinary approach employed to treat multiple missing teeth with a loss of VD is described. The patient receives a temporary prosthesis by increasing the vertical dimension.A definitive reconstruction using a fixed prosthesis in the maxillary arch and mandibular ant region and a flexible partial denture in the mandibular arch was carried out following validation of the newly established restorative vertical dimension. A dentist can improve a patient's quality of life by providing functional harmony and aesthetic comfort through appropriate diagnosis and treatment planning