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Full Mouth Rehabilitation
Full mouth rehabilitation refers to the reconstruction of the natural contacts among upper and lower teeth by the use of inlays, Onlays,
crowns, bridges and implants, which are harmonious with the overall health of the oro-facial complex.
There are a number of factors due to which the natural contacts among teeth in the same arch (upper or lower) and between opposing arches (upper and lower) are lost. The loss of natural contacts disturbs the alignment in the jaws, hinders the chewing ability of the patient, can cause immense sensitivity in a lot of teeth and can cause food lodgement in different areas in the mouth. Some of the common reasons which cause loss of natural contact
Missing Teeth ‐
our posterior teeth or molars are responsible for the major chewing that takes place in our mouth. We have 6 pairs(one upper and one lower counterpart together forms a biting pair) of molar teeth including our wisdom teeth (third molars). In most situations, only 4 functional pairs (wisdom don’t aid in chewing in majority circumstances due to awkward placement) are being utilized by us. Among these 4 pairs or 8 molar teeth, losing even one can cause a serious imbalance in our biting capacity by rendering its opposite biting partner useless. A number of missing molars for a long period of time will destroy the natural harmony and balance among the dentition and would need posterior and anterior realignment/rehabilitation.
Excessive tooth decay can reduce the amount of tooth structure present in our mouth. Reduction in the amount of tooth structure in our biting table would lead to increased stresses and eventually loss of natural occlusion.
Stress-related wear/attrition ‐
over a period of time individuals above 40 years of age show patterns of stress-related wear in teeth. These are visible as flattening of the incisal/biting edges of the teeth. Over years of wear, the loss of tooth structure reduces the height of the tooth and makes them really sensitive by exposing the nerve. Such wear patterns require immediate treatment. Habit-‐ breaking in cases of tooth grinding and night grinding also needs immediate attention.
Tooth Structure loss due to erosion ‐
Excessive gastric acid reflux/acidity can cause the acid present in the stomach to reflux into our mouth, the drop in pH in the mouth and increase in acidity harms and dissolves the enamel on the tooth. This opens by the natural contacts in the teeth and causes sensitive teeth.
Abfraction/ habits -
Abfraction is a type of tooth wear caused by hard manual tooth brushing, use of harmful hard bristles that abrade the enamel. This type of tooth wears mostly occurs at the neck of the teeth near the gum margins and make them prone to breakage etc.
What this treatment can do
This treatment enhances the ability of our teeth to chew efficiently, greatly influences the way we look, make our tooth function free of sensitivity.
Usually, patients in their middle ages above 35 are candidates for this treatment. Signs are usually visible in such ages where teeth are worn out but still not loose in their socket and need not be extracted. Often losing part of the tooth or the entire tooth can lead to excessive stress on our chewing muscles. This stress will not only make the jaw muscles sore but can also cause headaches and sleep problems.
Rehabilitation of function and aesthetics in the entire mouth will lead to comfort in your daily life.
Various way of doing FMR
Inlays/ Onlays ‐ when a part of tooth structure is missing, ceramic inlays and onlays are fabricated to restore the missing portion of the tooth.
Crowns ‐ Circumferential coverage is provided by crowns where root canal treatment might be needed and there is the presence of gross tooth structure loss.
Implant/ bridge ‐ when the entire tooth is missing, an implant or bridge will be required to restore the gap due to the missing tooth
How the Procedure is done at Coral Dental
When the patient first reports to the clinic with the problem of food lodgement, sensitivity, jaw pain-‐ we are led to checking for generalized symptoms for the patient.
This is done in 3 steps:
Charting missing teeth – We chart the number of missing teeth by an intraoral examination
Charting teeth needing endodontic therapy ‐ A full mouth X‐ray, electric pulp testing and temperature sensitivity test is performed for each tooth individually. The endodontic burden is calculated and the sensitive teeth are isolated. These teeth are then taken up quadrant-‐wise for treatment spread over multiple appointments.
Charting tooth wear‐ Biting surfaces of all teeth are seen. In a normal scenario, there is a Curve of spee that naturally exists in our mouth which arranges the teeth according to our skeletal structure. Once the biting table shows wear, loss of curves of occlusion occurs and this eventually creates an imbalance. Patient’s bite records are made to analyse the biting pattern that currently exists in his mouth.
After the patient’s intra-oral and radiographic charting is done, digital impressions are recorded for the patient.
Face ‐ Bow and centric relation record are also recorded.
These help to plan the treatment for the patient when the patient comes in his second visit. The tooth height, contour and anatomy is digitally designed in software and kept ready. A dummy set of new teeth is also printed digitally.
In the SECOND VISIT – Teeth are prepared to receive restorations and the dummy set in given to the patient as their first trial set. Any premature contacts are checked and adjusted. During this trial phase, we are able to visualize the final treatment as would occur in the mouth. Any changes if required are done at this step. This is a vital step in the success of the treatment, just like a Test-‐Drive. Any damage to these temporary set is noted in the subsequent appointment and the bite is re-‐balanced.
Once the trial period of 6-‐8 weeks is over, we can go ahead and provide CAD-‐CAM ceramic restorations to the patient as the final step.
Cost of the treatment
At Coral dental, the cost is kept extremely transparent with the patient. It will depend on the number of restorations we will be using.
An implant can cost between-‐ 20-‐80,000 depending on the case, type of implant etc.
An Inlay/Onlay/ Crown – can cost anywhere between 5000-‐18000 INR
A simple multiplication of the number of restoration with the cost per restoration gives us an estimate of the price.
For every patient, we provide the digital treatment planning, records and temporary crowns as an inclusion in the treatment. Nothing extra is charged from the patient for his temporary restorations.
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