Full mouth Rehabilitation Case#1

53 years old patient came to the clinic complaining from Bad Esthetics and loss of masticatory function due to loss of teeth. on clinical and Radiographic examination revealed the following: 1- Rampant caries of all Maxillary anterior teeth, carious #47 & #48 , grade III mobility of #46 with deep perio-endo legion of mesial Root.

Intraoral Record (preoperative)

Preoperative Radiograph

Chief Complain
1- Bad Esthetics
2-loss of function

History & Habits

-multiple extraction due to periodontal disease and badly decayed teeth

- heavy smoker

- Bad oral Hygiene

Treatment Plane

-Extraction of : #14 R.R & #46 #48

- Ultrasonic scaling followed by manual scaling & polishing.

- Caries Removal & indirect Pulp capping & RMGI for 3 months to allow proper oral hygiene and reduce smoking before definitive treatment.

-Recall After 3 months, and we noticed the Following :-
1- No signs or symptoms of previously treated tooth with RMGI.
2- No signs of following proper Oral hygiene instruction or reducing smoking

-partial removal of old RMGI and Final Restoration with Composite using dentine shade A3 and Enamel shade A3.
- teeth and oral environment cannot accept Fixed Prothesis, so Removable Partial Denture were the plane of choice to replaced the missing teeth.

Procedure

-After scaling

Proper Isolation for best prognosis of Indirect Pulp capping

Carful Caries removal
"you can see the pulp champer clearly"

Indirect pulp capping using light cured Theracal
"before removing Excess material"

Temporary Restoration using RMGI To allow better Oral hygiene
and Follow Up after 3 months

After 3 months

-Recall After 3 months, and we noticed the Following :-
1- No signs or symptoms of previously treated tooth with RMGI.
2- sadly, No signs of following proper Oral hygiene instruction or reducing smoking.

Definitive Treatment

1- Extraction of hopeless tooth #46 and non strategic tooth #48.

2-partial Removal of old RMGI and replacing it with composite.
3- Restoring carious #47 MOD with composite

4-enamelopalsty of occlusal surface of #47 to give proper Inter arch space

5-funcational cusps flatening to decrease latral forces of #24 & #34
6- primary impression using Alginate
7- Final impression using medium rubber base.