[EO-14] Full Mouth Rehabilitation Treatment for Posterior Bite Collapse in Patient with Autoimmune Disease: A Prosthodontic Approach
[Abstract]
[Introduction]
Autoimmune diseases have a 61% higher risk of tooth loss1, and premature loss without tooth replacement is one of the etiologic factors of Posterior Bite Collapse (PBC)2. Untreated PBC may accelerate periodontitis progression, temporomandibular disorders (TMD), heightened fremitus, increased tooth loss, anterior flaring, and Occlusal Vertical Dimension (OVD) reduction2. Comprehensive treatment in prosthodontics is needed to overcome this issue.
[Case Summary and Treatment Details]
A 55-year-old female patient with autoimmune disorders who already sign the informed consent, with clinical findings: multiple teeth loss, anterior flaring and guidance loss, wear dentition, inadequate inter-arch space, and a reduction in OVD. Willis's method to establish new OVD (+4mm), record digitally using IOS, digital wax-up and mock-up was performed. After the adaptation period (6 weeks), the final restoration consisting of a layered zirconia fixed-fixed bridge, porcelain veneers, composite restoration, zirconia crowns and overlays was done.
[Progress and Discussion]
Treating autoimmune patients will encounter various prosthodontic limitations, such as implant placement and metal restoration, due to delayed wound healing and metal hypersensitivity3. The digital workflow was planned to optimize occlusion and enhance aesthetics. The tooth structure was preserved using a minimally invasive preparation. Given that autoimmune therapy involves medication, aftercare is essential for prolonged comprehensive prosthodontic total rehabilitation. To summarize, the digital approach addresses comfort, aesthetics, and efficient and effective treatment for PBC in patients with autoimmune conditions4.
[References]
1) Maarse F, Jager DHJ, Forouzanfar T, et al. Tooth loss in Sjögren’s syndrome patients compared to age and gender matched controls. Medicina Oral Patologia Oral y Cirurgia Bucal. 2018;23(5):e545-e551
2) Nakamura SS, Donatelli D, Rosenberg ES. Posterior Bite Collapse: Guidelines for Treatment Based on Form and Function. Int J Periodontics Restorative Dent. 2022;42(3):351-359
3) Bjørklunda G, Dadarb M, Chirumboloc S, et al. Metals, autoimmunity, and neuroendocrinology: Is there a connection?. Environmental Research. 2020;187:109541
4) Mangano F, Veronesi G. Digital versus analog procedures for the prosthetic restoration of single implants: A randomized controlled trial with 1 year of follow-up. Biomed Res Int. 2018;2018:5325032
[Introduction]
Autoimmune diseases have a 61% higher risk of tooth loss1, and premature loss without tooth replacement is one of the etiologic factors of Posterior Bite Collapse (PBC)2. Untreated PBC may accelerate periodontitis progression, temporomandibular disorders (TMD), heightened fremitus, increased tooth loss, anterior flaring, and Occlusal Vertical Dimension (OVD) reduction2. Comprehensive treatment in prosthodontics is needed to overcome this issue.
[Case Summary and Treatment Details]
A 55-year-old female patient with autoimmune disorders who already sign the informed consent, with clinical findings: multiple teeth loss, anterior flaring and guidance loss, wear dentition, inadequate inter-arch space, and a reduction in OVD. Willis's method to establish new OVD (+4mm), record digitally using IOS, digital wax-up and mock-up was performed. After the adaptation period (6 weeks), the final restoration consisting of a layered zirconia fixed-fixed bridge, porcelain veneers, composite restoration, zirconia crowns and overlays was done.
[Progress and Discussion]
Treating autoimmune patients will encounter various prosthodontic limitations, such as implant placement and metal restoration, due to delayed wound healing and metal hypersensitivity3. The digital workflow was planned to optimize occlusion and enhance aesthetics. The tooth structure was preserved using a minimally invasive preparation. Given that autoimmune therapy involves medication, aftercare is essential for prolonged comprehensive prosthodontic total rehabilitation. To summarize, the digital approach addresses comfort, aesthetics, and efficient and effective treatment for PBC in patients with autoimmune conditions4.
[References]
1) Maarse F, Jager DHJ, Forouzanfar T, et al. Tooth loss in Sjögren’s syndrome patients compared to age and gender matched controls. Medicina Oral Patologia Oral y Cirurgia Bucal. 2018;23(5):e545-e551
2) Nakamura SS, Donatelli D, Rosenberg ES. Posterior Bite Collapse: Guidelines for Treatment Based on Form and Function. Int J Periodontics Restorative Dent. 2022;42(3):351-359
3) Bjørklunda G, Dadarb M, Chirumboloc S, et al. Metals, autoimmunity, and neuroendocrinology: Is there a connection?. Environmental Research. 2020;187:109541
4) Mangano F, Veronesi G. Digital versus analog procedures for the prosthetic restoration of single implants: A randomized controlled trial with 1 year of follow-up. Biomed Res Int. 2018;2018:5325032