A Full Mouth Rehabilitation of an Asthma-Associated Patient With Tooth Surface Loss: A Case Report.

Tooth surface loss (TSL) is multifactorial and, when severe, it can severely impact the quality of life. Although carbonated soft drinks, with their high sugar and acid content, are a common cause of TSL, the effects do not usually mandate full-mouth rehabilitation. Nevertheless, when combined with other factors such as parafunctional habits or other drivers of high consumption, TSL can be severe. Here we present the case of a 35-year-old man who presented with mild to severe TSL throughout the oral cavity caused by erosion and attrition. Causative factors were heavy consumption of soft drinks for years to quench thirst caused by asthma, side effects of asthma-related medications, and other parafunctional habits. The eight-step approach was as minimally invasive as possible, considering the severe presentation of TSL, and offered the patient a more durable treatment option than previously provided resin-based composite restorations. Presenting this case allows us to discuss the causes of TSL and also describe full mouth rehabilitation of TSL at increased occlusal vertical dimension with indirect restorations. We also demonstrate the integration of removable and fixed options, when progressing complex restorative cases.

Pain assessment, cognitive and cortical changes with full mouth rehabilitation in a group of children.

BACKGROUND: A change in professionals' perspectives on the value of general anesthesia (GA) for pediatric patients, including those with disabilities, medical conditions, severe oral issues, and challenging behaviors. Full-mouth rehabilitation under GA allows for the comprehensive treatment of all oral health problems in a single visit, without requiring the child's active participation. Extensive dental problems are often associated with severe dental pain, which can impact cognitive function, including perception, attention, memory, reasoning, language, communication, and executive functions. Individuals experiencing pain tend to perform less optimally cognitively. AIM: This study aimed to investigate changes in cognition, brain function, and cortical alterations in children who underwent extensive dental rehabilitation under GA. PATIENTS ANDMETHODS: Thirty uncooperative, healthy children aged 6-12 with extensive dental issues were enrolled. Pain levels were assessed using the FLACC and WBFPS scales before treatment, one week after, and three months later. Cognitive assessments, including the WCST, processing speed, digit span, and Trail Making Test, as well as EEG measurements, were also performed. RESULTS: The results showed a significant improvement in pain levels reported by the children or their caregivers after the dental procedures, both at one week and three months. All cognitive measures, such as digit span, processing speed, and WCST performance, demonstrated substantial improvements after the treatment. The Trail Making Test also exhibited statistically significant variations before and after the dental procedures. Additionally, the MOCA test revealed a notable improvement in cognitive skills following the treatment. Furthermore, the EEG power ratio, an indicator of changes in the power balance within each frequency band, showed a statistically significant difference after the dental procedures. CONCLUSION: the findings of this study suggest that full-mouth rehabilitation under GA can lead to improved pain management, as well as enhanced cognitive and brain functions in children. FUTURE PERSPECTIVES: More clinical studies with a longer follow-up period and a different age range of children are required to investigate the connection between brain function and oral rehabilitation involving restorations or occlusion issues.

Rehabilitation of a Patient With Maxillary Defect and Severe Attrition Using Obturator Prostheses: A Case Report.

Surgery for palate lesions may result in oro-nasal/antral communication, which reduces a person's quality of life by affecting swallowing, speech, and food reflux. The shape and size of this obturator prosthesis might vary based on the severity of the defect. This case report describes the prosthetic rehabilitation of the patient with post-COVID mucormycosis and generalized attrition of teeth using an obturator and full mouth rehabilitation.

Evaluation of Changes in Oral Microflora in Children with Early Childhood Caries after Full Mouth Rehabilitation.

Aim: To evaluate the change in microflora in children suffering from severe early childhood caries (ECC) after full mouth rehabilitation. Materials and methods: A total of 60 children, aged 3-5 years suffering from severe ECC who fulfilled the inclusion and exclusion criteria were included in the study. Pooled plaque samples were taken and subjected to quantitative reverse transcriptase polymerase chain reaction (PCR) to obtain baseline mean values of Streptococcus mutans (S. mutans), Streptococcus sobrinus (S. sobrinus), Candida albicans (C. albicans), and Candida dubliniensis (C. dubliniensis) before full mouth rehabilitation was done under general anesthesia. Posttreatment samples were collected at 6, 12, and 18 months. Wilcoxon signed-rank test was used to compare the mean values of S. mutans, S. sobrinus, C. albicans, and C. dubliniensis before and after full mouth rehabilitation. Results: A total of 60 patients recruited for the study were present at the follow-up at 6 and 12 months. At 18 months, 55 patients returned, and five were lost due to follow-up. A statistically significant reduction was seen in all microorganisms at 6, 12, and 18 months compared to baseline values. At 18 months a slight increase in S. mutans, S. sobrinus, and C. albicans was seen. C. dubliniensis was not detected in any cases after full mouth rehabilitation. Caries recurrence was seen in four patients at 18 months. Conclusion: Significant reduction of S. mutans, S. sobrinus, C. albicans, and C. dubliniensis was seen at 6, 12, and 18 months. A complete reduction of only C. dubliniensis was seen. A significant but not permanent reduction of S. mutans, S. sobrinus, and C. albicans. Caries recurrence was seen in 7.27% of patients at 18 months. How to cite this article: Mathew MG, Jeevanandan G, Rathod NN. Evaluation of Changes in Oral Microflora in Children with Early Childhood Caries after Full Mouth Rehabilitation. Int J Clin Pediatr Dent 2024;17(1):21-25.

Interdisciplinary full mouth rehabilitation of a patient with amelogenesis imperfecta from childhood to young adult-hood: A 12-year case report.

Treatment of patients with amelogenesis imperfecta extends over many years, from childhood to early adulthood. Their management at any age is complex and has to be adapted in relation to therapies validated in the general population.

Less Is More: A Case Report on All-on-4 Prosthesis.

Severe alveolar ridge atrophy following tooth removal poses a common and worsening issue in edentulous jaws, affecting patient comfort and quality of life. The All-on-4 approach involves axially positioning two anterior implants and distally orienting two posterior implants, reducing cantilever length and enabling prostheses with 12 teeth. This less invasive option, utilizing distal tilting of implants at 30°, offers biomechanical advantages and has shown short-term success, though long-term research is limited. Immediate-loading treatments are gaining popularity for their high survival rates. Understanding the biomechanics of implant-supported prostheses is crucial for long-term success, emphasizing the importance of optimal occlusal schemes. Challenges such as bone defects and surgical complexity have led to the exploration of achieving full-arch fixed restorations with fewer implants, building upon Brånemark's early work with four implants. The All-on-4 concept, originating in 1999, proves to be a viable treatment option, providing excellent long-term results and improved load distribution in challenging clinical circumstances. This case report explores the successful rehabilitation of a jaw using the All-on-4 implant prosthesis concept, a technique strategically placing four implants in completely edentulous jaws to support a fixed, immediately loaded prosthesis.

Prosthetic Rehabilitation of All-on-Six Implant-Supported Prosthesis: A Case Report.

This clinical report explores the effectiveness of dental implants for rehabilitating fully edentulous arches, with a focus on the all-on-six treatment approach. Implant-supported fixed restorations, particularly using six implants, are presented as an expected and cost-effective solution for the rapid repair of the edentulous patient, avoiding the need for bone grafting. This report details the successful rehabilitation of a patient's completely edentulous arches using the all-on-six concept, highlighting the meticulous planning and execution involved. It concludes that precise diagnostic and implant planning, along with thorough attention to all the features, is crucial for successful implant-supported fixed prostheses, with the all-on-six concept offering improved clinical and radiological outcomes for atrophied maxillae.

Prosthodontic rehabilitation of two siblings with hypoplastic (type 1) amelogenesis imperfecta: A case report.

Amelogenesis imperfecta is a rare genetic disorder that interferes with normal enamel formation. Of the 4 main types of amelogenesis imperfecta, hypoplastic (type 1) is the most prevalent, characterized by a quantitative alteration in enamel. The pitting or reduced thickness of the enamel results in generalized hypersensitivity, increased susceptibility to caries and infection, attrition, and a loss in vertical dimension of occlusion. Prosthodontic management of these patients can be challenging not only functionally and restoratively, but also from an emotional and psychosocial standpoint. This clinical report describes the prosthodontic management and rehabilitation of two young adult siblings with hypoplastic (type 1) amelogenesis imperfecta.

Evaluation of Factors Affecting Clinical Outcomes of Full Mouth Rehabilitation Under General Anaesthesia for Children With Early Childhood Caries: A Prospective Cohort Study.

AIM: This study was designed to evaluate the factors affecting the clinical outcomes of full mouth rehabilitation under general anaesthesia for children with early childhood caries (ECCs). MATERIALS AND METHODS: A prospective cohort of 200 children with early childhood caries and requiring dental rehabilitation under general anaesthesia was evaluated and treated. Children were recalled at six-month intervals for a period of two years and evaluated for the recurrence of caries and the need for repeat treatment of failed cases. RESULTS: 86.5% of the patients adhered to the six-month recall visits for 24 months. An overall caries recurrence rate of 14.5% was seen. Children who did not adhere to the follow-up plan and visited ad hoc had the highest caries recurrence rate (88%). CONCLUSION: Good compliance with postoperative instructions after full mouth rehabilitation resulted in good oral hygiene and a limited recurrence of caries. Patients with poor compliance with recall visits and postoperative instructions had high rates of caries recurrence. Rehabilitation under general anaesthesia can be considered a viable treatment option for children diagnosed with early childhood caries.

The Evaluation of Postoperative Complications and Oral Health-Related Quality of Life Following Dental General Anesthesia for Early Childhood Caries.

Aim The study aims to evaluate the postoperative complications and oral health-related quality of life (OHRQoL) following dental general anesthesia for early childhood caries (ECC). Materials and methods Two hundred children aged between three and six requiring full-mouth rehabilitation for general anesthesia were recruited for the study. Demographic data and oral health-related quality of life using the Early Childhood Oral Health Impact Scale (ECOHIS) were collected before the surgery. Postoperative complications and oral health-related quality of life were evaluated after 24 hours and at a one-week follow-up appointment. Results All 200 children returned for the follow-up appointment after one week. Pain was found to be the most common postoperative complication after 24 hours (52%) and one week (6%). The oral health-related quality of life showed a significant improvement after one week (P < 0.001) Conclusion Children may experience a postoperative complication after full-mouth rehabilitation, which resolves within a week. Dental pain was the most common operative complication in the present study. Oral health-related quality of life showed significant improvement after full-mouth rehabilitation.

Interdisciplinary rehabilitation using CAD-CAM technology for a young patient with severe malocclusion and amelogenesis imperfecta: A 5-year follow-up case report.

Treatment of acute cases of amelogenesis imperfecta is challenging in children due to the absence of a consensus statement on therapy recommendations. This article presents the effectiveness of an interdisciplinary approach, including orthodontics, orthognathic surgery, and prosthodontics using digital technology, in a child with amelogenesis imperfecta and skeletal deformities. The early management over a 6-year period had a very positive impact on the quality of life related to oral health. The full-mouth rehabilitation in adulthood with all-ceramic crowns showed a fully satisfactory result after 60 months of follow-up.

Evaluation of Change in Quality of Life, Dental Fear and Dental Anxiety in Young Children Following Full-mouth Dental Rehabilitation under General Anesthesia for Early Childhood Caries.

AIM: To evaluate the change in quality of life, dental fear, and dental anxiety in young children following full-mouth dental rehabilitation under general anesthesia for early childhood caries. MATERIALS AND METHODS: About 200 children who were diagnosed with early childhood caries requiring full-mouth rehabilitation under general anesthesia were recruited after obtaining parental consent. Oral health-related quality of life (OHRQoL) was measured using the Early Childhood Oral Health Impact Scale (ECOHIS). Dental fear was evaluated using Children's Fear Survey Schedule-Dental Subscale and dental anxiety was evaluated using the Facial Image Scale. Scores were taken on the day of intervention, and after 14 days when the child reported for posttreatment follow-up. RESULTS: All 200 participants returned for a follow-up visit after 2 weeks. The child impact section was reduced from 15.7 ± 4.1 to 7.7 ± 1.9 after treatment. The family impact section was reduced from 9.6 ± 2.7 to 3.5 ± 2.6 after treatment. A statistically significant difference was seen in both sections when pre-and posttreatment values were compared (p < 0.001). The total ECOHIS showed statistically significant improvement as the pretreatment score of 21.6 ± 9.5 reduced to 11.2 ± 4.2 showing 51.9% improvement in OHRQoL after full-mouth rehabilitation under general anesthesia was done (p < 0.001). Dental fear and anxiety among the participants showed a statistically significant reduction after treatment was done and most participants were found to be less fearful of doctors, dentists, and injections after treatment. CONCLUSION: Full-mouth rehabilitation was found to be a reliable treatment modality to improve the OHRQoL of children suffering from early childhood caries. CLINICAL SIGNIFICANCE: Significant improvement was seen in the OHRQoL within 2 weeks after treatment and most participants were found to be less anxious and fearful toward dentists and dental treatment. Comprehensive dental rehabilitation under general anesthesia has been proven to be an effective treatment modality for early childhood caries and a productive treatment technique to reduce dental fear and anxiety.

Reclaiming the Smile: Full Mouth Rehabilitation of a Generalized Attrition Patient Using the Hobo Twin-Stage Technique.

This clinical report details the successful rehabilitation of a 63-year-old male patient with severe tooth wear, a reduced vertical dimension of occlusion, and esthetic concerns. The Hobo twin-stage procedure addressed these issues while improving the patient's oral health and quality of life. After ensuring adequate oral hygiene, the treatment began with scaling and root planning, followed by diagnostic impressions. An occlusal splint was fabricated, followed by a diagnostic wax-up and tooth preparation. Full-arch impressions of prepared teeth were made using the addition of silicon elastomeric impression material, and chairside provisional crowns were fabricated. The working casts were mounted on a semi-adjustable articulator, and the metal copings were tried on before being built up in porcelain. The patient achieved successful outcomes and expressed satisfaction with the treatment. The Hobo twin-stage technique and porcelain-fused-to-metal crowns can be viable approaches for restoring the teeth's form and function while enhancing the patient's oral health and esthetics. However, regular follow-up appointments and good oral hygiene maintenance are essential for the long-term success of the treatment.

Managing the transition to a complex full mouth rehabilitation utilizing injectable composite.

OBJECTIVE: This article describes the use of flowable injectable composite resins to facilitate transitional treatment of a complex complete mouth rehabilitation. CLINICAL CONSIDERATIONS: Some patients require urgent and complex complete mouth rehabilitations that are time and cost intensive. Financial considerations can prevent some patients from pursuing treatment. This can result in the oral conditions worsening over time and compromising the long-term prognosis of the teeth. CONCLUSIONS: Injectable composite resins can be used as a transitional bonding material for complex cases using an injection molding technique utilizing clear indices obtained from a diagnostic waxing. This allows for a full mouth rehabilitation to be performed in a single appointment, producing instant results. CLINICAL SIGNIFICANCE: Transitioning with injectable composite as demonstrated in this case will immediately stabilize an otherwise deteriorating situation in a cost-effective way and allows patients to address the realities of financial or time constraints when transitioning to more durable porcelain restorations over a period of years.

Restorative Rehabilitation of a Patient With Tooth Wear: A One-Year Clinical Follow-Up Report.

Tooth wear is a multifactorial process of complex aetiology. It may be considered a physiological or pathological process depending upon the rate and degree of occurrence. The patients may present with symptoms of sensitivity, pain, headaches or recurrent loss of restorations and prostheses, leading to loss of function. This case report describes the rehabilitation of a 65-year-old male patient with intrinsic dental erosion combined with generalised attrition. The restorative treatment aimed at restoring anterior guidance, establishing a stable occlusion for the patient with minimal intervention.

3D-Printed Overlay Template for Diagnosis and Planning Complete Arch Implant Prostheses.

Dental implants are a reliable alternative to treating edentulism. In clinical situations where the dentition has been severely affected by partial edentulism, advanced wear, or periodontal disease, establishing important occlusal elements such as the occlusal plane, incisal guidance, and esthetics can be hard to visualize at the diagnostic stage. Contemporary data-acquisition technologies such as 3D scanners and CAD/CAM systems permit the precise manufacture of highly complex devices applicable to any stage of restorative treatment. The present clinical report presents an alternative technique for evaluating the projected artificial tooth relationships, vertical dimension, and occlusal plane in patients with severely weakened dentition by using a 3D-printed overlay template.

Full-Mouth Rehabilitation of a Patient with Sjogren's Syndrome with Maxillary Titanium-Zirconia and Mandibular Monolithic Zirconia Implant Prostheses Fabricated with CAD/CAM Technology: A Clinical Report.

Dental implants have become a well-established treatment modality for the management of complete and partial edentulism. Recent advancements in dental implant systems and CAD/CAM technologies have revolutionized prosthodontic practice by allowing for the predictable, efficient, and faster management of complex dental scenarios. This clinical report describes the interdisciplinary management of a patient with Sjogren's syndrome and terminal dentition. The patient was rehabilitated using dental implants and zirconia-based prostheses in the maxillary and mandibular arches. These prostheses were fabricated using a combination of CAD/CAM and analog techniques. The successful outcomes for the patient demonstrate the importance of appropriate use of biomaterials and the implementation of interdisciplinary collaboration in treating complex dental cases.

Mandibular Distalisation for Tooth Wear in Patients Requiring Mandibular Protrusion for Sleep Apnoea.

BACKGROUND: Pathological tooth wear is an increasing concern and may require intervention and occlusal rehabilitation. Often the treatment includes distalisaton of the mandible to restore the dentition in centric relation. Obstructive sleep apnoea (OSA) is another condition treated my mandibular repositioning but in this case by an advancement appliance. The authors have a concern that there could be a group of patients with both conditions where distalisation for their tooth wear management would be contrary to their OSA treatment. This paper aims to look at this potential risk. METHODS: A literature search was carried out using the following keywords (OSA or sleep apnoea or apnea or snoring or AHI or Epworth score) and for tooth surface loss (TSL or distalisation or centric relation or tooth wear or full mouth rehabilitation). RESULTS: No studies were identified which considered the effect of mandibular distalisation on OSA. CONCLUSION: There is a theoretical risk that dental treatment involving distalisation may adversely affect patients at risk of OSA or worsening their condition due to the modification of airway patency. Further study is recommended.

Evaluation of Clinical Success, Caries Recurrence, and Oral Health-Related Quality of Life of Children Undergoing Full Mouth Rehabilitation for Early Childhood Caries: A Prospective Cohort Study.

AIM: This prospective cohort study aimed to assess the clinical success, caries recurrence, and oral health-related quality of life of children undergoing full mouth rehabilitation for early childhood caries under general anesthesia. The study sought to understand the long-term impact of these interventions on early childhood caries (ECC) management. METHODOLOGY: The study included 300 children aged three to six years diagnosed with ECC requiring full mouth rehabilitation under general anesthesia. The assessment included clinical success of various dental treatments, caries recurrence rates, and oral health-related quality of life using the Early Child Oral Health Impact Scale at baseline, 12 months, and 24 months post-treatment. Specialized caries preventive protocols were implemented, including education on oral hygiene, reminders, and nutritional guidance. RESULTS: 272 children attended the 12-month follow-up, out of which 11 children had new carious lesions. Two hundred fifty-two children were reported for the 24-month follow-up, in which 19 children reported new carious lesions. The clinical success rate of treatment was found to be high. The oral health-related quality of life showed a significant and sustained improvement from baseline to 12 months and further improvement at 24 months post-treatment. CONCLUSION: Full mouth rehabilitation under general anesthesia is an effective approach for managing ECC in young children, with high clinical success rates and significant improvements in the oral health-related quality of life over two years. Preventive oral health strategies are necessary to maintain these positive outcomes and improve the overall well-being of affected children.

Method Presentation of a New Integrated Orthodontic-Conservative Approach for Minimally Invasive Full Mouth Rehabilitation: Speed Up Therapy.

The materials available today allow for extensive oral rehabilitations in a non-invasive way, and often an orthodontic preparation is useful and, thanks to the use of clear aligners, is predictable and comfortable. A preliminary study of the wax-up, mock-up, and set-up allow the clinician to plan every aspect of the treatment in detail. Furthermore, the procedure offers the patient an intuitive and understandable view of the expected final result. The new proposed method, called "speed up therapy", allows for the integration of the orthodontic set-up with the mock-up technique, simulating the occlusal and aesthetic components of the planned restoration, in all details. The clinical case presented, demonstrates step by step the predictability and clinical reliability of the proposed procedure. The final clinical result coincides exactly with the initial mock-up and demonstrates that the proposed method is predictable and reliable. The correct execution of the technique is rigorously customized, and its success is operator dependent, both for the clinical aspects and for the dental laboratory. Thus, the visualization of the objectives of the treatment constitutes a decisive support for the clinician and provides the patient with the possibility of benefiting from an immediate improvement by making it easier for them to accept a treatment plan. The visualization also includes an orthodontic phase that potentially lengthens the treatment but makes the realization more conservative and predictable.