Professional Documents
Culture Documents
Lecturer, Depart ment of Prosthodontics, A.B. Shetty Memorial Institute of Dental Sciences, Mangalore, Karnataka,
India
2
Professor, Depart ment of Prosthodontics, A.B. Shetty Memorial Institute of Dental Sciences, Mangalore,
Karnataka, India
3
Professor & HOD, Depart ment of Prosthodontics, A.B. Shetty Memo rial Institute of Dental Sciences, Mangalore,
Karnataka, India
4
P.G. Student, Department of Prosthodontics, A.B. Shetty Memorial Institute of Dental Sciences, Mangalore,
Karnataka, India
5
P.G. Student, Department of Prosthodontics, A.B. Shetty Memorial Institute of Dental Sciences, Mangalore,
Karnataka, India
ABSTRACT
Co mplete mouth rehabilitation is a dynamic functional endeavour and it embodies the correlation and integration of
all co mponent parts into one functioning unit. Over time have evolved various concepts and philosophies to attain
reconstruction and rehabilitation of the entire dentit ion, satisfying all the related factors. This case series describes
cases requiring full mouth rehabilitation t reated following Twin Table Philosophy and Twin Stage Philosophy by
Sumiya Hobo and Pankey Mann Schuyler Philosophy considering the requirements of the rehabilitation. It also
describes briefly the principle behind each philosophy as well as the various pros and cons of each and its
application in various scenarios.
Keywords: hobo; full mouth rehabilitation; pankey- mann
INTRODUCTION
1.
2.
To
replace
imp roperly
designed
and
3.
crowns,
bridges
and
partial
dentures.
Affected
treatment
and
achieving
Unacceptable
function,
dentition,
harmony
and TMJs.
BIOLOGICA L
CONSIDERATIONS
DURING
To
1.
attain
the
various
goals
of fu ll
mouth
system structures
2.
3.
Stable TMJs
4.
Stable occlusion
5.
6.
Co mfortab le function
7.
Optimu m esthetics
(termed
centric
be
INDICATIONS
FOR
FULL
M OUTH
REHABILITATION
31
Int J Dent Case Reports
2.
working side.
3.
control of parafunction
and
4.
5.
FUNCTIONA L ASPECTS OF FULL M OUTH
REHABILITATION (10)
In order to accomp lish these goals, the following
Co mplete
mouth
rehabilitation
is
dynamic
1.
PART
Examination,
Diagnosis,
2.
3.
2.
3.
1.
4.
centric occlusion
guidance
and
RECONSTRUCTION
closely
allied
with
this
part
of
the
reconstruction. (2, 3)
One of the most practical philosophies is the rationale
of treat ment that was orig inally organized into a
(5)
1.
Schuyler. (5)
1.
2.
32
Int J Dent Case Reports
3.
4.
5.
6.
7.
8.
9.
series
neither
at one time.
all times.
reconstructed.
All
of
appointments.
posterior
occlusal
It
is
contours
was observed.
are
first.
and
dentist.
10. The
PMS
philosophy
of
occlusal
CASE REPORT
33
Int J Dent Case Reports
Figure 2:
a)
Wax
preparation
of
the
mandibular
Tooth
preparation
of
lower
completed
developed anterior guidance to create a predetermined, harmonious disclusion with the condylar
path. The technique utilizes 2 d ifferent customized
incisal guide tables. The first incisal table is termed
incisal table without disclusion. It is fabricated by
preparing die systems with removable anterio r and
posterior segments. This table helps us achieve
uniform contacts in the posterior restorations during
eccentric movements. The other incisal table is made
when the articu lator can simu late border movements
by placing 3 mm plastic separators behind the
condylar elements. This is termed the incisal
guidance with disclusion. The first incisal guide table
34
Int J Dent Case Reports
Figure 3
a)
excursive movements
technique.
movements. (Figure 4, 5, 6)
CASE REPORT:
A 44 year o ld healthy male reported to the
Depart ment of Prosthodontics with a co mplaint of
worn out, sensitive teeth and difficu lty in chewing. It
was diagnosed to be a case of severe generalized
attrition and abrasion and a treatment plan was
formulated
to
rehabilitate
Hobostwin
table
radiographic
evaluation
the
dentition
technique.
using
Pre-operative
indicated
endodontic
Occlusal
plane
was
evaluated
a)
using
b) Occlusal
p lane
established
using
Maxillary
full
arch
tooth
preparation
completed.
35
Int J Dent Case Reports
mo lars
philosophy:
as
advocated
in
Hobos
Twin
Stage
movement. Since
ANGLE ON M OLARS
CUSP ANGLE
CUSP
A NGLE
protrusive
cusp
angle
segment
is
produce
fabricated.
25
anterior
help
ON
MOLARS
Sagittal
removable
anterior teeth
(working
side)
Frontal lateral effective
cusp
angle
20
(non
working side)
36
Int J Dent Case Reports
Figure 5
a)
a)
posterior teeth.
c)
working side
Contraindications:
1.
Teeth
preparation
was
completed
and
final
2.
3.
4.
dimension of
37
Int J Dent Case Reports
Figure 7
a)
b)
working cast
d)
working cast
(Figure 7, 8)
Modification
of art iculator
settings
(
CONDITION
1)
Modification
of art iculator
settings
(CONDITION
2)
Figure 8
a)
Horizontal
condylar
guidance
25
Lateral
condylar
guidance
15
Anterior
guidance
25
Lateral
anterior
guidance
10
40
15
45
20
relation
c)
CONCLUS ION
In
rehabilitation
rehabilitation
the
tradit ional
imp lies
broad
the
sense
full
involvement
mouth
of
all
38
Int J Dent Case Reports
by
various
in
esthetics,
function,
relieving
REFERENCES
1. Irving Goldman: The goal of full mouth rehabilitation , J
restoration
factors: improvement
of
occlusal
the
condylar
path
has
been
39
Int J Dent Case Reports