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ABSTRACT
This study aims at identifying practical ways of approaching social cases, and creating a hierarchy of the final
functions of restoration. In 2008 the Clinical Base for Learning from the Faculty of Dental Medicine, Iasi,
recorded for the Partially Stretched Edentation Clinic and Therapy course a prevalence of biterminal partial
edentation (Class I Kennedy)-66.39 per cent from the total number of patients, followed by uniterminal
edentation (Class II Kennedy), having 40.24 per cent of the clinical cases, whereas INTERCALATE edentation
(Class III Kennedy) , frontal edentation (Class IV Kennedy), and subtotal edentation have about 20.12.1 per
cent each. The clinical form of edentation contributes to the election of a proper therapeutic solution as well as
the odonto-parodontal and muco-osseous status of each clinical case, the patient’s general condition or the socio
economic and technical factors leading to a modern, classical or social prosthesing. An important aspect to be
taken into account is the large percentage of 41.61.2/ social cases diagnosed with partially edentation, pleading
for provisional prostheses with an established role in therapy, which sometimes may become social prosthesing
- an outstanding clinical reality. Social cases should be solved with a view to restoring functionality such as
lower level redimensioning and cranio-mandibulary repositioning, whereas aesthetic requirements fall into
therapies based on metallo-ceramic and hybrid prosthesing or implanto-prosthetic therapy.
75
Romanian Journal of Oral Rehabilitation
Vol. 5, No. 4, October - December 2013
Figure 1. The distribution of the studied group according to the edentation class.
The clinical form of edentation contributes to An important aspect to take into account is
the election of a proper therapeutic solution the large percentage of 61.2 social cases
as well as the odonto-parodontal and muco- diagnosed with partially edentation, pleading
osseous status of each clinical case, the for provisional prostheses with an established
patient’s general condition or the socio role in therapy, which sometimes may
economic and technical factors leading to a become social prosthesing - an outstanding
modern, classical or social prosthesing. clinical reality (fig. 2).
Figure 2. Social cases vs tax payers-patients with partially stretched edentation treated at the
Clinical Base of the Dental Medicine Faculty-the 5th year of study
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Romanian Journal of Oral Rehabilitation
Vol. 5, No. 4, October - December 2013
acrylic prosthesing for the other-used either 45, according to epidemiological studies. The
temporarily or for social reasons until the statistic data describing the general status of
achievement of prosthetic field specific the patients in our group of study came to
rehabilitation at that level-followed by a support this idea. Partially stretched and
therapeutic solution based on modern subtotal edentation was most frequent at
biomaterials and technologies (fig. 3). patients between 55-64 years with a
As clinical entity, the partially edentation prevalence at female patients (Iasi, 2008) –
is to be found most frequently after the age of fig. 4.
Figure 3. Social vs modern therapeutic solutions for patients with partially edentation treated at
the Clinical Base of the Faculty of Dental Medicine, the5th year of study
Figure 4. A female patient aged 49 with maxillary and mandibulary biterminal edentation
(Class I Kennedy) is representative
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Romanian Journal of Oral Rehabilitation
Vol. 5, No. 4, October - December 2013
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Romanian Journal of Oral Rehabilitation
Vol. 5, No. 4, October - December 2013
wrinkles and folds partially disappear, elements as therapeutic solution. The uneven
whereas the nasal cloazon fall and the jaw elements at the mandibulary level created
close position to the nose cannot be reduced problems for restoring occlusive rapports (fig.
as presented at the second clinical case (fig. 8).
7). The model analysis showed a modified
Aesthetic recovery may become art, palatal vault and dull relief which led to
considering that non aesthetic prosthesing canine amputation in order to restore the
disfigures the patient affecting his/her life and maxillary configuration, cranio-mandibullary
behavior, leading to inferiority complexes. and upper lip repositioning (fig. 9).
Total or partially removable prosthesing The microstomy aspects provided some
should restore the patient’s natural particular aspects of therapy, the upper labial
appearance. scar presence increasing the approach
This case presents sequellae of maxillo- difficulty. The model for diagnosis was an
palatine split. Unfortunately surgery did not important stage in creating the prosthesis with
provide a favorable prosthetic field and respect to the lower level redimensioning,
ortognate surgery could not be used. We upper lip support configuration and occlusive
selected scaffold prosthesing with special rapport restoring (fig. 10).
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Romanian Journal of Oral Rehabilitation
Vol. 5, No. 4, October - December 2013
Scaffold /skeletal prosthesing used special cases the clinical case particularity imposed
means of holding, support and stabilization at the solutions.
the canine level. The canines were amputated
and covered by corono-radiculary devices CONCLUSIONS
repositioning the upper lip and restoring the Social cases should be solved with a view
dento-stomato-facial balance (Fig. 11). to restoring functionality such as lower level
There should be taken into account redimensioning and cranio-mandibulary
therapeutic solutions, the clinical case repositioning, whereas aesthetic requirements
particularities as well as socio-economical fall into therapies based on metallo-ceramic
criteria in taking a proper decision (Fig. 12). and hybrid prosthesing or implanto-prosthetic
Although the last two patients were social therapy.
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Romanian Journal of Oral Rehabilitation
Vol. 5, No. 4, October - December 2013
REFERENCES
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