Multidisciplinary Rehabilitation of a Patient with Bruxism

Implantologist: Paulo Malo, DDS, PhD

Prosthodontist: Ricardo Almeida, DDS

Lab: MALO CLINIC Ceramics

Clinical Team Location: Lisbon, Portugal

Website: www.maloclinics.com
Category: Clinical Case

Specialties: Oral Surgery, Implantology, Prosthodontics

Title: Multidisciplinary reahabilitation of a patient with bruxism- Clinical case

Prosthetics: : NobelProceraTM zirconia crowns

This clinical case refers to a 69-year-old male patient who came to MALO CLINIC Lisbon complaining of an inability to chew properly and aesthetic concerns.

Thorough clinical and radiographic analysis revealed: multiple missing teeth; posterior bite collapse associated with reduced vertical dimension; altered interocclusal space; teeth with generalized wear and attrition; altered tooth position and multiple diastemas. Anamnesis reported parafunctional dental habits (grinding and clenching).

The vertical dimension of occlusion and maxillomandibular relationship were restored with an anterior jig.

The treatment plan also included multiple extractions (18,28,38,48)*, NobelSpeedyTM Groovy implants placement (24,25,35,36,45,46,47)* and endodontic treatments (16,15,14,13,12,11,21,22,23,26,33,34,41,42,43,44)* followed by reconstruction with D.T. Light-Post®(Bisco Inc.; Schaumburg, USA) and rehabilitation with provisional crowns.

The treatment was concluded with the cementation of NobelProceraTM zirconia crowns, over teeth and easy abutments (NobelBiocare ® USA, LLC, Yorba Linda , CA), all done with GC Fuji PlusTM (GC, América, Inc.).

The restoration of a correct vertical dimension in cases like this is the key aspect to success in the rehabilitation of patients with parafunctional habits.

At the 3,5 year follow-up, the only complication observed was a root fracture in tooth 14*, with subsequent extraction and placement of a NobelProceraTM zirconia crown over an implant.

*According to FDI

Case Photos

Initial OPG

Initial situation: Extra-oral frontal view in smile position; Intra-oral frontal view.

Intra oral occlusal views after conclusion of the definitive rehabilitation

- Intra-oral frontal view after conclusion of the definitive rehabilitation.

Extra-oral, frontal view in smile position after conclusion of the definitive rehabilitation.

Final OPG with 3,5 years follow-up, after the placement of implant and provisional crown in tooth 14