Multi-disciplinary Prosthetic Rehabilitation. Clinical Case Report

Resumen

In present days, evolution in Dentistry and changes in prosthetic techniques and materials have rendered patients more demanding in matters concerning aesthetics, function, and comfort.  Issues involving face and teeth require interaction of several dental disciplines, with the aim of attaining prevention, function and aesthetics, which can be attained through well organized communication. Multidisciplinary prosthetic rehabilitation meets that goal.

A multidisciplinary treatment is based upon diagnosis, planning and therapeutic procedures^1,2. Treatment planning can initiate with a visualization of the final result. If several disciplines were not to be  involved in the comprehensive treatment, results could result compromised³.

Objective

Step by step description of clinical phases, in a multidisciplinary treatment based upon diagnosis and planning. Different specialties are involved: Surgery, Implantology, Periodontics, Endodontics, Oral Prosthesis and Occlusion. The inclusion of all these disciplines will achieve stability in the periodontal tissues as well as tissues surrounding future  implants, recovery of periodontal architecture and masticatory function, as well as attaining acceptable aesthetic results and gaining the patients aesthetic and functional satisfaction.

Clinical Case Presentation

47 year old female patient, in general good health, some missing teeth, inappropriate  prosthetic work, loss of periodontal support as well as aesthetic and functional alterations. Treatment plan was decided upon, and divided into four phases: the first phase consisted on tooth extraction and implant placement. The second phase  involved canal treatment and re-treatment with stump reconstruction, which involved  the making of a guide for partial coronary conformation. The third prosthetic phase involved treatment of soft tissues, impressions, implant rehabilitation, characterization, cementing with the CAD-CAM Procera® system and occlusal splint. The fourth phase involved periodontal and prosthetic control.

Conclusion

Treatment success was based upon the following factors: 1) Maintenance  of  periodontal and  tissues surrounding the implant, 2) Periodontal architecture recovery, 3) Masticatory function recovery, 4) Obtaining acceptable aesthetic results, 5) Patient `s satisfaction with respect to aesthetics and function.