Preprosthetic Orthodontic Intervention for Management of a Partially Edentulous Patient with Generalized Wear and Malocclusion

Authors

  • AVINASH S. BIDRA BDS, MS, FACP,

    Corresponding author
    1. Assistant Professor and Assistant Program Director, Post-Graduate Prosthodontics, University of Connecticut Health Center, Farmington, CT, USA
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  • FLAVIO URIBE DDS, MS

    1. Associate Professor and Program Director, Division of Orthodontics, University of Connecticut Health Center, Farmington, CT, USA
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  • This article is accompanied by commentary, Preprosthetic Orthodontic Intervention for Management of a Partially Edentulous Patient with Generalized Wear and Malocclusion, Douglas E. Ford, DDS, MS, MS. DOI 10.1111/j.1708-8240.2011.00492.x

Avinash S. Bidra, BDS, MS, FACP, University of Connecticut Health Center, 263 Farmington Avenue, L6078, Farmington, CT 06030, USA; Fax: 860-679-1370; email: avinashbidra@yahoo.com

Abstract

ABSTRACT

Prosthodontic management of patients with generalized wear of dentition has been well documented in the literature. Although prosthodontic treatment is designed to correct minor malocclusion and interdental spacing, patients with severe malocclusion accompanied by generalized wear may require preprosthetic orthodontic intervention. Few articles have described the comprehensive treatment of adult orthodontic patients with severe wear of teeth. This article describes the multidisciplinary management of an adult patient with multiple missing posterior teeth, malocclusion, and severe wear of anterior teeth. Preprosthetic orthodontic treatment was planned using occlusograms, visualized treatment objective, and sectioned diagnostic waxing for movement of teeth, according to the prosthodontic treatment plan. Temporary anchorage devices were used to accomplish complex orthodontic tooth movements. The definitive treatment included reestablishing appropriate esthetics, and occlusion and restoration of the entire maxillary arch and posterior mandibular dentition with metal ceramic and full gold restorations. At a 2.5-year follow-up, positions of teeth and integrity of the restorations remained stable. Importance of preprosthetic orthodontic treatment and challenges in management of complex esthetic and functional rehabilitations are discussed in this article.

CLINICAL SIGNIFICANCE

Knowledge of occlusograms, visualized treatment objectives, and temporary anchorage devices can aid in multidisciplinary treatment planning for complex esthetic and functional rehabilitations.

(J Esthet Restor Dent 24:88–102, 2012)

Ancillary