Full mouth rehabilitation with fixed teeth supported prosthesis following hobo twin stage technique – A Case Report
Background: Worn dentition is a common problem encountered by most people in the last decade. Rehabilitation of a full mouth needs individual attention and proper treatment planning, which is very challenging for partial edentulous cases where bilateral teeth are missing and collapsed vertical dimension leaves inadequate restorative space. Treatment of these cases is complex and needs to apply standard principles while designing and fabricating prostheses. Case presentation: A 41-year-old female presented with a history of difficulty in chewing and poor appearance. Examination revealed that the patient had missing teeth in the maxilla (12, 13, 14, 15, 23, and 24), in the mandible (46 and 47), and in teeth 11, 21, 22, 25, 36, 37, 43, 44, and 45 were root canal treated, of which 21, 22, and 25 did not have any coronal structure and 36 had a discharging sinus. The periodontal condition of the remaining teeth was good and the vertical dimension was reduced. This patient had multiple missing and badly damaged anterior teeth. Hence, Hobo and Takayama twin stage method was used to re-establish the anterior guidance for full mouth rehabilitation. Conclusion: Worn dentition requires a very careful and calculative approach due to its complex nature. Hobo twin stage technique is based on case studies from which the mathematical values for anterior guidance and posterior disocclusion are determined and thus minimizes the clinical procedure duration and produces good masticatory function.
- Revathi D, Jeya K, Raja S, Jacob A, Nathan G. Full mouth rehabilitation using Hobo’s twin stage technique- A case report interdisciplinary approach. Int J Prostho Rehabil. 2022;3(2):23-36. doi: 10.56501/intjprosthorehab.v3i2.669
- Nag S. Multidisciplinary approach for a patient with severely worn dentition by full mouth rehabilitation-restoration of esthetics, function, and oral health: A clinical case report. Int J Sci Res. 2015;6:413-417.
- Dawson PE. Functional Occlusion - from TMJ to Smile Design. 1st ed. New York: Elsevier Inc.; 2008. p. 430-452.
- Chandrasekar V, Chidembaranathan AS, Balasubramanium M. Holistic management of mutilated dentition. Sci Dent J. 2020;4:33-38. doi: 10.4103/SDJ.SDJ_46_19
- Hobo S, Takayama H. Twin-stage procedure. Part 1: A new method to reproduce precise eccentric occlusal relations. Int J Periodont Rest Dent. 1997;17:112-23.
- Hobo S, Takayama H. Oral Rehabilitation, Clinical Determination of Occlusion. Carol Stream, Illinois: Quintessence Publishing Co. Inc.; 1997. p. 32-33.
- Small BW. Occlusal plane analysis using the Broadrick flag. Gen Dent. 2005;53:250-252.
- Dadarwal A, Sharma V, Sareen K, Dharmendra KV, Rahul M. Reclaiming the smile: Full mouth rehabilitation of a generalized attrition patient using the hobo twin-stage technique. Cureus 2023;15(5):e39260. doi: 10.7759/cureus.39260
- Tiwari B, Ladha K, Lalit A, Dwarakananda Naik B. Occlusal concepts in full mouth rehabilitation: An overview. J Indian Prosthodont Soc. 2014;14:344-351. doi: 10.1007/s13191-014-0374-y
- Dawson PE. Evaluation, Diagnosis and Treatment of Occlusal Problems. St Louis: CV Mosby Co.; 1974. p. 148-149.