Full Mouth Rehabilitation: Strategies for Success

mm Written by Andrew Sedler

Dentists and technicians both face major challenges when performing a full mouth reconstruction. The goal of a full mouth reconstruction is to reestablish functional harmony, pulpal health, esthetics, and protect the dentition from further damage in patients with excessive wear.

Reconstructing a person’s mouth can improve his or her self-esteem and health in general. The success of these types of cases depends on proper planning and support.

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Prescribing a Full Mouth Rehabilitation
Full Mouth Rehabilitation - Burbank Dental Lab

The most common reason for prescribing full mouth rehabilitation is tooth wear. In most cases, people choose this treatment plan to regain a more youthful and functional dentition. Uncovering the possible etiological factors is extremely important to determine the cause of the wear.

Some of these may be:

  • External forces, such as a toothbrush, are responsible for creating abrasion. Teeth usually have a notch near the gumline after experiencing this type of wear.
  • Flattening a tooth’s surface is usually the result of grinding or a poor bite.
  • Tooth abfraction caused by misaligned bites or grinding.
  • Erosion of the surface of the tooth is caused by acid in the mouth, usually as a result of dietary issues.
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Understanding the Patient’s Vertical Dimension of Occlusion (VDO)

It’s important to take into account muscle issues, periodontal disease, and the temporomandibular joint when considering full-mouth rehabilitation. To achieve improved oral health, all of these factors must work together. The path to restoration can be started after a proper evaluation has been conducted.

Once a patient’s VDO is identified, then the appropriate approach to restore the case is determined. Patients who exhibit excessive wear usually can be placed in one of the following categories:

  • Drooping at the corners of the mouth is a sign of vertical dimension loss. In these cases, the VDO needs to be increased.
  • There is no loss of vertical dimension or space. To make room for restorations, gingivoplasty and adjustments may be necessary.
  • There is no loss of vertical dimension, and space is limited. In these cases, the anterior usually shows wear, while the posterior usually shows minimal wear. In these cases, restorations may need to be repositioned, surgically removed, or orthodontically fixed.

In addition to assessing the patient’s dental health, an evaluation of the vertical dimension of the occlusion, the available space, and the position of the condyles can be used to determine restorative options.

The Treatment Plan

Collaboration with Burbank Dental Lab can begin after the diagnosis is made. Involving the dental lab early on in the process is important in helping to ensure a successful outcome. A functional diagnostic wax-up and mounted preliminary models will help solidify the proposed treatment plan. During this stage, the proposed treatment should be communicated to the lab so that a wax-up can be prepared.

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The Diagnostic Wax-Up
Full Mouth Rehabilitation - Burbank Dental Lab

The diagnostic wax-up allows the lab to work up the case according to the clinician’s specifications. This will be the roadmap to the final restorations, as the patient will be able to try out the restorations prior to the final restoration being fabricated. During this phase, the patient can approve the proposed case or request changes.

To properly fabricate the restorations, it is best to follow these steps:

  1. Provide the dental lab with the number of teeth being restored along with the type of restorations.
  2. Any tissue surgery that will be necessary should be disclosed.
  3. Will there be any changes to the VDO?
  4. Provide the proposed material choice for the final restorations
  5. A preliminary shade selection

Along with the above information, digital photos are also necessary. Burbank Dental Lab recommends sending along the following photos:

  • Forehead to chin full face
  • A close-up of the full smile
  • A close-up of the lips resting

Along with this information, either a digital impression or a traditional impression will be provided for the wax-up process.

When the wax-up is completed, the following will be provided:

  • The completed wax-up
  • The stent to make the temporaries
  • Preparation Guide (if requested)
The Staging Strategy

The staging strategy of a full-mouth case is dependent on the VDO situation of the case. How the preparation and bite records are taken is an important step in creating proper function.

This step is dependent on whether:

  • The completed wax-up
  • The stent to make the temporaries
  • Preparation Guide (if requested)

Download our Cosmetic Success Guide for greater detail on how to handle each of the specific VDO strategies.

Cosmetic & full Mouth Checklist Success Guide by Burbank Dental Lab
The Provisionals
Full Mouth Rehabilitation - Burbank Dental Lab

Provisionals are provided to the patient so the proposed new treatment can be worn and evaluated. To ensure patient satisfaction, it is important to gather feedback from the patient regarding their experience with the temporaries. After the patient has approved the proposed case, provide the following:

  • The same series of pictures that were sent with the initial wax-up request.
  • With the provisionals in place, take new bites.
  • If there are no VDO or occlusal adjustments made to the provisionals, then a bite, temp to temp, should be taken.
  • If there are VDO or occlusal adjustments, then three bites should be taken of the altered provisionals to the preparations.
  • Impressions of the provisional models
  • A new prescription detailing all of the pertinent information regarding the restorations, patient’s requests, and shade selection.
The Final Restoration

After the provisionals have been approved, the case is ready for the final restoration. The restorations are fabricated using the material best suited for the specific case.

Full Mouth Rehabilitation - Burbank Dental Lab

All of the preplanning information is used in the final case. It is highly recommended that a bisque try-in (see the above image) is done before the final glaze. This will allow the opportunity to make any adjustments to the case, and then the final glaze can be completed.

Full Mouth Rehabilitation - Burbank Dental Lab

A full-mouth case can be a life-changing experience for a patient.

These cases are challenging; however, if the proper steps are followed, and a plan is developed, these cases can be completed with exceptional results.

Do you have a patient that might benefit from a full mouth rehabilitation?

Call or chat with a Burbank Dental Lab team member for help on your next case.

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Fabrication
of the future
is here!

Burbank Dental Lab has three new state-of-the-art Carbon M2 printers. We are very excited about the options that these cutting-edge printers will allow us to offer our dental clients. Here are some of the advantages that these printers will begin to deliver to you and your dental practice.

Our New
State-Of-The-Art
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Carbon offers a highly dependable 3D manufacturing solution for many dental applications with its breakthrough Digital Light Synthesis™ technology, enabled by a wide range of dental materials.