| Purpose:Through utilizing modern all ceramic restoration material, recontouring technique and occlusion theories. We are able to correct minor malocclusion/crowding at the same time achieve great cosmetic result which might enhance pt's quality of life in a very short course of treatment.Material and technique:Ideal pt should be over 40 years old, with minor crowding or malocclusion and oppose or not suitable for lengthy orthodontic treatment.. The candidate must not have severe conditions that he or she must need orthodontic treatment, No TMJ symptoms presented. We have selected 10 subjects both male and female over 40 years old. Total of 68 anterior teeth that have slight crowding, discoloration, and malocclusion .First we evaluate patient's need, appearance, discover chief complaint. Pt's chief complaint was unsatisfactory, facial profile, discoloration of teeth, crowding and length of front teeth. Pt refused orthodontic treatment due to the length of time needed for treatment.Study model impression taken and pours. It was discovered that pt does not have protrusive and lateral interference in occlusion. Patient's midline is slightly off while the horizontal plan of occlusion is not parallel to inter-pupillary line. Gingiva overgrowth was detected. Preliminary composit build up done. Pt was satisfied with the preliminary result. Alginate impression taken, plastic stent fabricated , Crown prepared. Endodontic treatment done if needed. Temp crowns placed and cemented, Final restoration placed in two weeks. Night guard/retainer fabricated.Result: After one year of study and reaseartch, it was found that full ceramic restoartion may achieve the same reasult and stability as conventioanl porcelain fuse to metal and orthondotic treatment. 1. Out of the 78 teeth only 1 exfoliated due to trauma.2. Only one case of gingival irratation on lower anterior tooth was noted.3. Post x–ray shows no bone resorption as compared to pre-xay4. Caries detected in one patient, who was later diagnosed with diebetes. No further decay advancement noted after the disease went under control.5. All subjects were happy with result of procedure. Both quality of life and confidence level have increase significantly.6. All subjects expressed the desire to doing this all again shall there be another chance.Conclusion: ceramic restoration has become increasingly popular in the past ten years. Advancement in press ceramic technology enable dental practitioner to placed non-metal restoration in order to achieve optimum aesthetic result while not compromising strength. Multidisciplinary treatment approach allow dentist to treatment minor mal-occlusion crowding in matter of weeks rather than years of conventional orthodontic treatment. When properly treatment planned and using the Golden Ratio Rules<1>, optimum cosmetic result is achieved. In this case we utilized giginvectomy electrosurge <2> for crown lengthening, noted that 3 mm biological width <3> should always be maintained. Facial profile must be taking into consideration while selecting mould. Eg. Oval shape face pt should be matched with oval shape mould. At last, the lenth of upper anterior crown should follow the curvature of lower lip smile line to prevent gap in between teeth and lower lip. F.S. sound phonetic <4> must also be taking into consideration. Finanal occlusion check with excursion and protrution interference shold be eliminated to prevent fracture or possible TMJ pain<5>. Night guard/occlusal guard<6> is also shown to prevent relapse and thereby achieving longevitiy result. |
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