The objective of full mouth rehabilitation is to minimize stresses from malfunction or poorly related oral parts so they do not damage tissues. This is done by distributing stresses evenly over many teeth and tissues. Reasons for full mouth rehabilitation include maintaining periodontal health, treating jaw issues, replacing missing/worn teeth, and improving aesthetics. Indications are restoring function, preserving remaining teeth, maintaining gum health, improving appearance, and reducing pain. Contraindications are mouths not needing extensive work that have no jaw symptoms - treatment should only occur if there is tissue damage. Patients requiring rehabilitation are classified based on degree of wear, available space, and relationship of bite.
The objective of full mouth rehabilitation is to minimize stresses from malfunction or poorly related oral parts so they do not damage tissues. This is done by distributing stresses evenly over many teeth and tissues. Reasons for full mouth rehabilitation include maintaining periodontal health, treating jaw issues, replacing missing/worn teeth, and improving aesthetics. Indications are restoring function, preserving remaining teeth, maintaining gum health, improving appearance, and reducing pain. Contraindications are mouths not needing extensive work that have no jaw symptoms - treatment should only occur if there is tissue damage. Patients requiring rehabilitation are classified based on degree of wear, available space, and relationship of bite.
The objective of full mouth rehabilitation is to minimize stresses from malfunction or poorly related oral parts so they do not damage tissues. This is done by distributing stresses evenly over many teeth and tissues. Reasons for full mouth rehabilitation include maintaining periodontal health, treating jaw issues, replacing missing/worn teeth, and improving aesthetics. Indications are restoring function, preserving remaining teeth, maintaining gum health, improving appearance, and reducing pain. Contraindications are mouths not needing extensive work that have no jaw symptoms - treatment should only occur if there is tissue damage. Patients requiring rehabilitation are classified based on degree of wear, available space, and relationship of bite.
All patients requiring full mouth rehabilitation have one problem in
common1: stress and strain. Usually the stress is due to malfunction or to poorly related parts of the oral mechanism. Our objective is to minimize these stresses so that they are not destructive. Stresses should fall within the capability of the tissues to withstand them and maintain a state of health. In order to prevent this stress from being destructive, the best thing to do is to distribute it evenly or an as great area as possible, over as many teeth and as much tissue as possible, with the teeth providing a means by which the forces are distributed.
Reasons for full mouth rehabilitation
1) The most common reason for doing full mouth rehabilitation is to
obtain and maintain the health of periodontal tissues.
2) Temperomandibular joint disturbance is another reason.
3) Need for extensive dentistry as in case of missing teeth, worn
down teeth and old fillings that need replacement.
4) Esthetics, as in case of multiple anterior worn down teeth and
missing teeth.
Indications of occlusal rehabilitation
Restore impaired occlusal function
Preserve longevity of remaining teeth
Maintain healthy periodontium
Improve objectionable esthetics
Eliminate pain and discomfort of teeth and surrounding
structures.
Contraindications for full mouth rehabilitation
Malfunctioning mouths that do not need extensive dentistry and
have no joint symptoms should be best left alone. Prescribing a full mouth rehabilitation should not be taken as a preventive measure unless there is a definite evidence of tissue breakdown.
In short, it can be concluded that :
No pathology- No treatment.
Classification of patients requiring occlusal
rehabilitation
Classification by Turner and Missirlain (1984)4
The patients were classified into three categories
Category 1 - Excessive wear with loss of vertical dimension. Category 2 - Excessive wear without loss of vertical dimension of occlusion but with space available. Category 3 - Excessive wear without loss of vertical dimension of occlusion but with limited space available Category 1 A typical patient in this category has few posterior teeth and unstable posterior occlusion. There is excessive wear of anterior teeth. Closest speaking space of 3mm and interocclusal distance of 6mm. there is some loss of facial contour that results in drooping of the corners of mouth. Patients with dentinogenesis imperfecta with excessive occlusal attrition, around 35 years of age and appearing prognathic in
centric occlusion also belongs to this category.closest speaking
space of 5mm and interocclusal distance of 9mm indicates there is loss of occlusal vertical dimension with concomitant occlusal wear.
Category 2- Patient has adequate posterior support and histoty of
gradual wear. Closest speaking space of 1mm and interocclusal distance of 2-3mm. Continuous eruption has maintained occlusal vertical dimension leaving insufficient interocclusal space for restorative material. Manipulation of mandible into centric relation will often reveal significant anterior slide from centric relation to maximum intercuspation.
Category 3 Posterior teeth exhibit minimal wear but anterior teeth
show excessive gradual wear over a period of 20-25 years. Centric relation and centric occlusion are coincidental with closest speaking space 1mm and interocclusal distance 2-3mm. It is most difficult to treat because vertical space must be obtained for restorative material.
Classification by Breaker5
Group I Class I Patients with collapse of vertical dimension of occlusion because of shifting of existing teeth caused by failure to replace missing teeth.