Full Mouth Reconstruction
Our mouth is made up of hard and soft tissues. Hard tissue comprises of teeth and bone and soft tissue is comprised of our gums, tongue, cheeks and the muscles. Teeth are fixed in the bone with the help of a ligament called periodontal ligament. The teeth and bone are covered by our gums, and the whole complex of teeth and gums is surrounded by tongue on inside and cheeks on the outside of the mouth.
During our life time many problems can occur to hard and soft tissues which cause damage to our mouth.
- Most common disease which causes damage to our teeth is caries.
- Second most common disease is periodontal disease (disease of our gums) which causes loosening of teeth in our bone due to bone loss.
- Teeth are positioned in our jaw in such a way that they are complete harmony with each other which helps in chewing our food more efficiently. When any of the disease of hard and soft tissue damages the balance of teeth it causes disturbance in harmony of jaw (occlusion) and hence effect our chewing capability. When this happens we have to intervene with various techniques to bring back the balance of jaws for better chewing efficiency which is called full mouth reconstruction.
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Full mouth reconstruction is indicated when
- Multiple missing teeth: Missing teeth causes decreased efficiency of chewing food which causes the patient to swallow large lumps of food which in turn impairs digestion of food and bad stomach.
- Gum disease: Gum disease causes bad breath, swollen gums, bleeding gums, receding gums and bone loss. The teeth become loose and shaky in the bone decreasing the chewing capability
- Improper bite: Improper bite is caused by excessive grinding of teeth, broken teeth, crooked teeth.
- Smile design: smile design is done with the help of veneers, crowns and bonding. This is done when patient does not like his or her smile.
- Crooked teeth: Crooked teeth causes food to be lodged in between teeth and becomes difficult to clean causing bad breath, gum disease and improper bite in some cases.
- Loose dentures: Dentures are worn by patients who don’t have teeth, but sometimes they are not satisfied with Dentures as they rock in the mouth and move as we eat food causing lot of irritation to patient and impaired efficiency of chewing food.
How it is done
In full mouth reconstruction multiple missing teeth are replaced by implants, bridges, removable partial dentures, Full dentures.
- Introduction: Implants are titanium screws placed inside to bone to replace the missing tooth. We can replace single tooth, or multiple teeth with help of implants. If all the teeth are missing we can place 4-8 implants per jaw to replace teeth. There are different ways of loading the implants. In one technique we wait for 3-4 months after placing of implants and once we confirm the implant is stable we place a tooth over the implant. In other technique if we get good stability of implant in bone at the time of surgery we place the crown at the same time which is called immediate loading of the implant. In some conditions we take the teeth out and at the same time place the implants in the socket and is called immediate implantation. In cases of replacing all teeth in very old patients with severe health problem we can place only four implants and replace all teeth. This technique is called All-On-4. In this we convert the existing removable denture into fixed prosthesis.
- Basic Procedure: initially study models, X-rays and CT Scans are done to diagnose the quality and quantity of bone and position of vital structures is noted. Then after diagnosis we decide the no of implants and position of implants to be placed and is informed to the patient. They we do placement of implants and plan immediate or delayed placement of teeth over them according to bone quality.
- Time Required:Full mouth Implants generally we can finish the case by immediate loading which require 3-5 days.
If the bone quality is not good and we don’t get good stability of implants then we have to wait 3-4 months before we can place teeth on them.
All-on-4 case we place the implants and the teeth at the same time. This procedure require 3-5 days.
- Introduction: Bridge is an old and economical method of replacing the missing teeth. In this technique we shape the adjacent teeth and place joined crowns to replace the missing teeth. Generally bridge is done when we have sound multiple teeth to support the mouth.
- Basic Procedure:In this technique we take x-rays and study models of the patient and a firm diagnosis is made. Then we repair the mutilated teeth by fillings, root canal treatment, post and core buildups. Then we prepare teeth for the bridge, an impression is made and send to the lab. In between we take try in sittings to confirm fit and bite. Then final insertion of bridge is done.
- Time Required:Time require generally for bridge is 5- 8 days
Removable partial dentures
Removable partial dentures use plastic teeth to replace missing teeth. These plastic teeth are fixed on an acrylic plate and clasps are placed in the plate to take support from adjacent teeth.
- Basic Procedure: In this technique impressions are taken and then bite record is done on second sitting, then a try in is done to check the prosthesis before final insertion
- Time required: 3-5 days
Full mouth reconstruction involves various techniques to reconstruct the mouth which may involve aligning of teeth with invasiline, metal braces. Smile correction with veneers, crowns, bonding. Reconstruction of mutilated teeth with tooth colored fillings, inlays, onlays and crowns.
Time required depends upon the procedure of reconstruction to be done.
If full mouth implants has to be done we can finish the treatment in 3-5 days from placing of implants to fixing of teeth.
Bridges require 3-4 days from taking of impression to fixing of teeth.
Veneers requires 2-3 weeks from taking of impressions to final fixing on to the teeth.