4. INTRODUCTION
Patient arrived to the dental center seeking
restoring the esthetic and the function of his
mouth which is severely deteriorated by his bad
history of careless behavior toward his oral
hygiene.
He visited and consulted many dentist but he
refused the treatment planning by insisting on
replacing his missing teeth by FPD and crowning
the deteriorated teeth.
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5. EXAMINATION
Chief complain restoring the esthetic and the
function
Patient fits well
46, 45 are missing teeth.
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7. Points taken in consideration.
Due to the dental attrition there will be eruption of
the affected tooth with its alveolar bone.
The free way space ( due to the attrition ) could
not be completely compensated by the eruption
of the remaining teeth.
The free way space for CI is about 2-3 mm in the
premolar area 3-5 mm for CII and 1 mm or less
for CIII.
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8. Points taken in consideration
In CIII the dominated movement is open close so
that lateral forces are minimal, also there is
coincidence between the deep glenoid fossa and
the mandibular movements.
In class III there is coincidence between CO and
occlusion in CR
The neuro-muscular system is the least affected by
the pathologic changes so its considered as
reference after muscle relaxation.
Evaluation of VD changes for at least three months
and its reflexes on the NMS and TMJ.
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9. Points taken in consideration.
Teeth with short clinical crowns due to attrition or
caries should undergo crown lengthening to insure a
ferrule of 2-3 mm in the sound tissue of the affected
tooth.
If the damage attends 50% or more of the crown a
post should be used in the build up of the crown.
When the caries index is high the use of retraction
cord is mandatory when you take the final impression.
In case where the tooth crown is too short and there
no enough space use the pulp chamber crown.
Mutual protection between the anterior and the
posterior teeth.
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10. Points taken in consideration.
In complicated cases temporary restoration
should be done to reach a satisfactory esthetic
and functional permanent restoration.
Ten years success rate is about 95% for an
implant. A tooth with RCT + parapost with crown
has 90% success for ten years.
The bio mechanic principles of FPD.
The strategic teeth.
Treatment of complicated cases is the result of
cooperation between the different dental
specialties.
Treatment planning.
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