Objective of full mouth rehabilitation

All patients requiring full mouth rehabilitation have one problem in

common1: stress and strain.
Usually the stress is due to malfunction or to poorly related parts of the
oral mechanism.
Our objective is to minimize these stresses so that they are not
destructive. Stresses should fall within the capability of the tissues to
withstand them and maintain a state of health. In order to prevent this
stress from being destructive, the best thing to do is to distribute it evenly
or an as great area as possible, over as many teeth and as much tissue as
possible, with the teeth providing a means by which the forces are
distributed.

Reasons for full mouth rehabilitation

1) The most common reason for doing full mouth rehabilitation is to

obtain and maintain the health of periodontal tissues.

2) Temperomandibular joint disturbance is another reason.

3) Need for extensive dentistry as in case of missing teeth, worn

down teeth and old fillings that need replacement.

4) Esthetics, as in case of multiple anterior worn down teeth and

missing teeth.

Indications of occlusal rehabilitation

Restore impaired occlusal function

Preserve longevity of remaining teeth

Maintain healthy periodontium

Improve objectionable esthetics

Eliminate pain and discomfort of teeth and surrounding

structures.

Contraindications for full mouth rehabilitation

Malfunctioning mouths that do not need extensive dentistry and

have no joint symptoms should be best left alone. Prescribing a
full mouth rehabilitation should not be taken as a preventive
measure unless there is a definite evidence of tissue breakdown.

In short, it can be concluded that :

No pathology- No treatment.

Classification of patients requiring occlusal

rehabilitation

Classification by Turner and Missirlain (1984)4

The patients were classified into three categories

Category 1 - Excessive wear with loss of vertical dimension.
Category 2 - Excessive wear without loss of vertical dimension of
occlusion but with space available.
Category 3 - Excessive wear without loss of vertical dimension of
occlusion but with limited space available
Category 1 A typical patient in this category has few posterior teeth and
unstable posterior occlusion. There is excessive wear of anterior
teeth. Closest speaking space of 3mm and interocclusal distance
of 6mm. there is some loss of facial contour that results in
drooping of the corners of mouth.
Patients with dentinogenesis imperfecta with excessive occlusal
attrition, around 35 years of age and appearing prognathic in

centric occlusion also belongs to this category.closest speaking

space of 5mm and interocclusal distance of 9mm indicates there is
loss of occlusal vertical dimension with concomitant occlusal
wear.

Category 2- Patient has adequate posterior support and histoty of

gradual wear. Closest speaking space of 1mm and interocclusal
distance of 2-3mm.
Continuous eruption has maintained occlusal vertical dimension
leaving insufficient interocclusal space for restorative material.
Manipulation of mandible into centric relation will often reveal
significant anterior slide from centric relation to maximum
intercuspation.

Category 3 Posterior teeth exhibit minimal wear but anterior teeth

show excessive gradual wear over a period of 20-25 years. Centric
relation and centric occlusion are coincidental with closest speaking
space 1mm and interocclusal distance 2-3mm. It is most difficult to
treat because vertical space must be obtained for restorative material.

Classification by Breaker5

Group I
Class I Patients with collapse of vertical dimension of occlusion
because of shifting of existing teeth caused by failure to replace
missing teeth.