Abstract

Case Report

Twin-stage technique for occlusal rehabilitation of a mutilated dentition – A case report

Amarjeet Gambhir* and Gita Rani

Published: 28 May, 2020 | Volume 5 - Issue 1 | Pages: 006-010

Functional and aesthetic rehabilitation of an extremely worn dentition is one of the most challenging aspects of Prosthodontics. A thorough examination and diagnosis & selection of appropriate occlusal scheme are key factors to achieve optimal clinical outcome. Among the variety of techniques suggested in the literature, the twin-stage technique given by Hobo & Takayama has emerged as a popular choice for clinicians in recent times. Instead of the condylar path, it utilizes standard cuspal angle as the main determinant of articulation to produce predictable disocclusion in eccentric movements. It is relatively simple, does not require special armamentarium and can be incorporated easily with commonly used clinical techniques such as face bow transfer.

The present case report describes the full mouth rehabilitation of a severely mutilated dentition using Hobo’s twin-stage technique to achieve a functionally and aesthetically favourable outcome.

Read Full Article HTML DOI: 10.29328/journal.johcs.1001031 Cite this Article Read Full Article PDF

Keywords:

Full mouth rehabilitation; Twin-stage technique; Cuspal angle; Disocclusion

References

  1. Brown KE Reconstruction considerations for severe dental attrition. J Prosthet Dent. 1980; 44: 384-388. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/6997465
  2. Turner KA, Missirlian DM. Restoration of the extremely worn dentition. J Prosthet Den.t 1984; 52: 467-474. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/6389829
  3. Dawson PE. Functional occlusion- from TMJ to smile design. 1st ed. New York: Elsevier Inc.; 2008.
  4. Carlsson GE, Ingervall B, Kocak G. Effect of increasing vertical dimension on the masticatory system in subjects with natural teeth. J Prosthet Dent. 1979; 41: 284-289. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/283228
  5. Mann AW, Pankey LD. Concepts of occlusion; the P.M. philosophy of occlusal rehabilitation. Dent Clin North Am. 1963; 9: 621-636.
  6. Hobo S. Twin-tables technique for occlusal rehabilitation: Part I-Mechanism of anterior guidance. J Prosthet Dent. 1991; 66: 299-303. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/1800723
  7. Hobo S. Twin-tables technique for occlusal rehabilitation: Part II-Clinical procedures. J Prosthet Dent. 1991; 66: 471-477. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/1791556
  8. Schluger S, Youdelis RA, Page RC. Periodontal disease. Philadelphia: Lea & Febiger. 1971.
  9. 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: 113-123. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/9497706
  10. Hobo S, Takayama H. Twin-stage procedure. Part 2: A clinical evaluation test. Int J Periodont Rest Dent. 1997; 17: 457-463. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/9497734
  11. Shetty M, Joshi N, Prasad DK, Sood S. Complete rehabilitation of a patient with occlusal wear: a case report. J Indian Prosthodont Soc. 2012; 12: 191‐197. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/23997471
  12. Gupta T, Banerjee A, Banerjee S, Chakraborty N, Singh R. Full mouth rehabilitation of a patient with severe attrition using Hobo twin-stage procedure. Int J Prosthodont Restor Dent. 2011; 1: 177-181. PubMed: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3341744/
  13. Anil Kumar S, Radhakrishnan V, Sandhu HS, Sahoo NK. Full mouth rehabilitation of a case of rampant caries using a twin-stage procedure. Med J Armed Forces India. 2015; 71(Suppl 2): S429‐434. PubMed: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4705153/
  14. Verma K, Gowda EM, Kalra A, Verma R. Full mouth rehabilitation using twin-stage procedure-a case report. Ann Dent Spec. 2015; 3: 89-92.
  15. Dawson PE. Evaluation, diagnosis & treatment of occlusal problems. 2nd ed. St Louis: Mosby. 1989; 265.
  16. 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. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/25489156
  17. Kalra A, Sandhu HS, Sahoo NK, Nandi AK, Kalra S. Full-mouth rehabilitation using twin-stage technique. Int J Oral Health Sci. 2019; 9: 40-44.
  18. Mohindra R, Kumar D, Katiyar P, Malviya A. Full mouth rehabilitation by using Hobo’s twin-stage technique- a case report. University J Dent Scie. 2016; 2: 105-108.
  19. Hobo S, Takayama H. Re-evaluation of the condylar path as the reference for occlusion. J Gnatho. 1995; 14: 31-40.
  20. Hobo S, Takayama H. Effect of canine guidance on working condylar path. Int J Prosthodont. 1989; 2: 73-79. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/2597295
  21. Choukse V, Parmar A, Sharma N, Srivastava R. Full Mouth Rehabilitation using Hobo Twin-stage Technique. Int J Prev Clin Dent Res. 2017; 4: 319-323.
  22. Hobo S. Occlusion in temporomandibular disorders- treatment after occlusal splint therapy. Int Dent J. 1996; 46: 146-155. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/8886867

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