Department of Operative Dentistry and Endodontics, Aga Khan University Hospital, Karachi, Pakistan.
Department of Operative Dentistry and Endodontics, Bahria University Medical and Dental College, Karachi, Pakistan.
J Pak Med Assoc. 2023 Aug;73(8):1716-1719. doi: 10.47391/JPMA.6509.
This case report demonstrates the full mouth prosthetic rehabilitation of a patient with generalised compensated tooth wear and oral sub-mucous fibrosis (OSMF). A 50- year-old female with advanced tooth wear and concomitant OSMF presented to the clinic. She was managed in a sequential manner using an occlusal splint, extractions of hopeless teeth, root canal treatment of strategically important teeth, surgical crown lengthening of abutment teeth, and dental implants to replace missing dentition, followed by crown and bridgework to rehabilitate the dentition. All procedures were done on the principles of re-organised occlusal intervention. The outcome was a functional dentition with an aesthetic smile and a satisfied patient. The regaining of mouth opening among OSMF subjects is a challenge. The usual management is prescribing muscle stretching exercises, drugs, or surgery. In the present case, we managed to achieve significant improvement in mouth opening with occlusal splints. The use of such occlusal orthotics has never been reported.
本病例报告展示了一位广泛性补偿性牙齿磨损和口腔黏膜下纤维性变（OSMF）患者的全口义齿修复过程。一位 50 岁的女性患者，牙齿磨损严重，同时患有 OSMF，来到诊所就诊。我们采用序贯治疗的方法，使用咬合夹板、拔除无希望保留的牙齿、对重要的有牙髓病变的牙齿进行根管治疗、对基牙进行牙冠延长手术、植入牙种植体以替代缺失的牙齿，然后再进行牙冠和牙桥修复来修复牙齿。所有的治疗程序都遵循重新组织咬合干预的原则。治疗结果是患者获得了功能良好、美观自然的义齿，并且非常满意。OSMF 患者张口度的恢复是一个挑战。通常的治疗方法是口腔肌肉拉伸练习、药物治疗或手术。在本病例中，我们成功地通过使用咬合夹板显著改善了张口度。这种咬合矫正器的使用尚未有报道。
