Complete Oral Rehabilitation of a Patient with Class II Malocclusion: A Case Report
Article Sidebar
Main Article Content
Abstract
Introduction: The increase in overjet and overbite in a patient with class II malocclusion can affect the aesthetic and functional result of prosthetic treatment. Objective: To describe a complete oral rehabilitation through aesthetic and radiographic analysis; wax-up and mock-up; surgical conditioning of the oral cavity to receive implants and final restorations; rehabilitation of implants with fixed prostheses and individual crowns in the posterior sector and crowns and veneers in the anterior region, to restore aesthetics and function. Case presentation: Angle's class II patient with periodontal disease and bruxism. Phase I: Extraction and alveolar ridge preservation (26, 47); interdental bone regeneration (31, 32); implant placement (36, 46); maxillary sinus lifts and implant placement (14, 16, 24, 26). Phase II: Preparation for a fixed prosthesis (11-13) and individual crowns (21, 22, 23) of lithium disilicate (LS2), acrylic provisional (AlikeTM, GC® America Inc) with a metallic framework (18, 28) and crown lengthening in upper anterior sextant. Preparation of margins at the equigingival level and change of provisional. Lower anterior sextant preparation for LS2 veneers and provisional placement (ProtempTM, 3M™). Final impression with silicone (3M™ Imprint IITM, 3M™) and individual trays. Phase III: Cementation (Panavia™ V5 Clear kit, Kuraray) of LS2 restorations. Placement of metal-ceramic cemented fixed prostheses on upper implants and single metal-ceramic, cement-screwed crowns on lower implants. Extraction (18, 28). Finally, an occlusal splint with anterior guides was placed. Phase IV: Maintenance and periodic evaluation. A treatment plan was established in conjunction with periodontics to achieve the expected results; Surgical procedures allowed better adaptation of final restorations, and function and aesthetics were restored, thus reducing overjet, replacing missing teeth, and harmonizing the smile. Conclusions: It is essential to establish a treatment plan focused on correcting the alterations caused by a class II malocclusion in accordance with the needs of the patient.
Article Details
Citas en Dimensions Service
References
Campbell S, Goldstein G. Angle's classification – A prosthodontic consideration: Best evidence consensus statement. J Prosthodont. 2021; 30(S1): 67-71. DOI: 10.1111/jopr.13307
Angle EH. Classification of malocclusion. Dental Cosmos. 1899; 41: 350-357.
Bernhardt O, Krey KF, Daboul A, Völzke H, Kindler S, Kocher T, et al. New insights in the link between malocclusion and periodontal disease. J Clin Periodontol. 2019; 46(2): 144-159. DOI: 10.1111/jcpe.13062
Kaygısız E, Hacıömeroğlu AB, Yüksel S, Mümin M, Tortop T. The influence of abnormalities in the profile and overjet on psychological well-being. Turkish J Orthod. 2021; 34(1): 54-60. DOI: 10.5152/TurkJOrthod.2021.20038
He Y, Chen YC, Teng W, Fok ASL, Chew HP. Prosthetic correction of proclined maxillary incisors: A biomechanical analysis. Comput Math Methods Med. 2019; 7416076. DOI: 10.1155/2019/7416076
Giannetti L, Apponi R. Combined orthodontic and restorative minimally invasive approach to diastema and morphology management in the esthetic area. Clinical Case case report with 3-year follow-up. Case Rep Dent. 2020; 2020: 3628467. DOI: 10.1155/2020/3628467
Uzuner FD, Aslan BI, Dinçer M. Dentoskeletal morphology in adults with Class I, Class II Division 1, or Class II Division 2 malocclusion with increased overbite. Am J Orthod Dentofac Orthop. 2019; 156(2): 248-256.e2. DOI: 10.1016/j.ajodo.2019.03.006
Xie C, Meng Y. A case report of esthetic and functional correction of maxillary protrusion using a prosthodontics-centered multidisciplinary approach. Int J Periodontics Restorative Dent. 2016; 36(2): e33-40. PMID: 26901308
Fradeani M, Barducci G. Esthetic rehabilitation in fixed prosthodontics. Chicago, IL: Quintessence; 2004.
Caton JG, Armitage G, Berglundh T, Chapple ILC, Jepsen S, Kornman KS, et al. A new classification scheme for periodontal and peri-implant diseases and conditions - Introduction and key changes from the 1999 classification. J Clin Periodontol. 2018; 45(S20): S1-S8. DOI: 10.1111/jcpe.12935
Ruf S, Proff P, Lisson J. Zahn- und Kieferfehlstellungen - gesundheitliche Relevanz und Behandlung [Health relevance of malocclusions and their treatment]. Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz. 2021; 64: 918-923. DOI: 10.1007/s00103-021-03372-3
Al-Jasser RN. The effect of overbite and overjet on clinical parameters of periodontal disease: A case control study. Saudi Dent J. 2021; 33(4): 201-206. DOI: 10.1016/j.sdentj.2020.02.002
Sierwald I, John MT, Schierz O, Jost-Brinkmann PG, Reissmann DR. Association of overjet and overbite with esthetic impairments of oral health-related quality of life. J Orofac Orthop. 2015; 76: 405-420. DOI: 10.1007/s00056-015-0300-x
Kanavakis G, Krooks L, Lähdesmäki R, Pirttiniemi P. Influence of overjet and overbite on soft tissue profile in mature adults: A cross-sectional population study. Am J Orthod Dentofacial Orthop. 2019; 155(1): 57-63.e3. DOI: 10.1016/j.ajodo.2018.02.015
Cheng HC, Cheng PC. Factors affecting smile esthetics in adults with different types of anterior overjet malocclusion. Korean J Orthod. 2017; 47(1): 31-38. DOI: 10.4041/kjod.2017.47.1.31
Ng E, Tay JRH, Ong MMA. Minimally invasive periodontology: A treatment philosophy and suggested approach. Int J Dent. 2021; 2810264. DOI: 10.1155/2021/2810264
McGarry TJ, Nimmo A, Skiba JF, Ahlstrom RH, Smith CR, Koumjian JH, et al. Classification system for partial edentulism. J Prosthodont. 2002; 11(3): 181-193. DOI: 10.1053/jopr.2002.126094
Vig RG, Brundo GC. The kinetics of anterior tooth display. J Prosthet Dent. 1978; 39(5): 502-504. DOI: 10.1016/s0022-3913(78)80179-6
Robbins JW. Differential diagnosis and treatment of excess gingival display. Pract Periodontics Aesthet Dent. 1999; 11(2): 265-273. PMID: 10321231
Alfallaj H. Pre-prosthetic orthodontics. Saudi Dent J. 2020; 32(1): 7-14. DOI: 10.1016/j.sdentj.2019.08.004
Koubi S, Gurel G, Margossian P, Massihi R, Tassery H. A simplified approach for restoration of worn dentition using the full mock-up concept: Clinical case reports. Int J Periodontics Restorative Dent. 2018; 38(2): 189-197. PMID: 29447311
Yu H, Zhao Y, Li J, Luo T, Gao J, Liu H, et al. Minimal invasive microscopic tooth preparation in esthetic restoration: a specialist consensus. Int J Oral Sci. 2019; 11(3): 31. DOI: 10.1038/s41368-019-0057-y
Khan S, Musekiwa A, Chikte UME, Omar R. Differences in functional outcomes for adult patients with prosthodontically-treated and -untreated shortened dental arches: a systematic review. PLoS One. 2014; 9(7): e101143. DOI: 10.1371/journal.pone.0101143
Revista Odontológica Mexicana por Universidad Nacional Autónoma de México se distribuye bajo una Licencia Creative Commons Atribución-NoComercial-SinDerivar 4.0 Internacional.
Basada en una obra en http://revistas.unam.mx/index.php/rom.