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Techniques of full mouth rehabilitation

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akshi gvalani

on 4 June 2014

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Transcript of Techniques of full mouth rehabilitation

Philosophies in full mouth rehabilitation
a systematic review

Guided by:
Dr. Jyoti Karani Dr. Saloni Mistry
Professor, Guide, HOD Professor and Guide

Presented by:
Dr. Akshi Gvalani

Pankey Mann Schyuler technique
Hobo's twin table technique(twin stage technique )
Youdelis concept
Nyman and Lindhe's concept
Case 2 and 3 :
Pankey Mann Schuyler technique
Case 1 :
Int J Dent Case Reports 2013; 3(3): 30-39
Bharat Raj Shetty, Manoj Shetty, Krishna Prasad D, S. Rajalakshmi, Raghavendra Jaiman
Balanced articulation versus natural dentition
The following goals should be achieved when planning for an occlusal rehabilitation:
1) Static coordinated occlusal contact of the maximum number of teeth when the condyle is in comfortable, reproducible position

2) An anterior guidance that is in harmony with function in lateral eccentric position on the working side.

3) Disclusion by the anterior guidance of all posterior teeth in eccentric movements.

4) Axial loading of teeth in centric relation, interproximation, and function
What is occlusal rehabilitation ?
The term occlusal rehabilitation is defined as restoration of functional integrity of dental arches by the use of inlays, crowns, FPDs and partial dentures.
The aim is to provide an ordered pattern of occlusal contact and articulation to optimize oral function, health, occlusal stability, esthetics and comfort.
In order to accomplish these goals, the following
sequence is advocated by the PMS philosophy:
1. PART I : Examination, Diagnosis,Treatment planning and Prognosis

2. PART II : Harmonization of the anterior guidance for best possible esthetics ,function and comfort

3. PART III: Selection of an acceptable occlusal plane and restoration of the lower posterior occlusion in harmony with the anterior guidance in a manner that will not interfere with condylar guidance.

4. PART IV: Restoration of the upper posterior occlusion in harmony with the anterior guidance and condylar guidance. The functionally generated path technique is so closely allied with this part of the reconstruction.
Bonwills theory


1. Freedom from disease in all masticatory
system structures
2. Maintainable healthy periodontium
3. Stable TMJs
4. Stable occlusion
5. Maintainable healthy teeth
6. Comfortable function
7. Optimum esthetics
1. The restoration of multiple teeth which are
missing, worn, broken down or decayed

2. To replace
improperly designed
executed crown and bridge framework.

3. Treatment of
temporomandibular disorders
is also advised, though caution is advised.
intercondylar distance
condylar path
hinge axis position
maxilla to mandible relation
tooth size and form
vertical dimension of occlusion
anterior guidance
Twin table technique
sumiya hobo 1991

1. It is possible to diagnose and plan the treatment for entire rehabilitation before preparing a single tooth.

2. It is a well- organized logical procedure that progresses smoothly with less wear and tear on the operator, patient and technician.

3. There is never a need for preparing or building more than 8 teeth at a time.

4. It divides the rehabilitation into separate series of appointments. It is neither necessary nor desirable to do the entire case at one time.

5. There is no danger of getting at sea and losing patient’s vertical dimension. The operator always has an idea where he is at all times.

6. The functionally generated path and centric relation are taken on the occlusal surface of the teeth to be rebuilt at the exact vertical dimension to which the case will be reconstructed.

7. All posterior occlusal contours are programmed by and are in harmony with both condylar border movements and a perfected anterior guidance.

8. There is no need for t ime consuming techniques and complicated equipment.

9. Laboratory procedures are simple and controlled to an extremely fine degree by the dentist.

10. The PMS philosophy of occlusal rehabilitation can fulfill the most exacting and sophisticated demands if the operator understands the goals of optimum occlusion
Advantages of the Pankey Mann Schuyler technique:
Condylar factor
Anterior guidance : the influence on mandibular movements provided by the contacting surfaces of the maxillary and mandibular anterior teeth
Cuspal angle
Twin stage procedure
3mm spacers
1.1mm spacer
1mm and 0.5mm disclusion

I. Since the measurement of the condylar path is not necessary, complicated instruments such as the pantograph and fully adjustable articulator become unnecessary. Therefore, the Twin-Stage procedure is much simpler than the standard gnathological procedure, yet it follows gnathological principles.

2. The procedure can be indicated for almost every phase of restorative and prosthodontic work including the single crown, fixed prosthodontics. implants,
complete-mouth reconstructions, and complete dentures.

3, Since the condylar path is not used as the main determinant of occlusion. this procedure is suitable for restorative work for the transmandibular disorder patient, especially after occlusal splint therapy
Occlusal rehabilitation is
a radical procedure and should be carried out in
accordance with the dentist’s choice of treat ment
based on his knowledge of various philosophies
followed and clinical skills
Full transcript