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Case Reports
. 2024 Dec 25;13(1):7.
doi: 10.3390/dj13010007.

A Digital Approach for a Complete Rehabilitation with Fixed and Removable Prostheses: A Technical Procedure

Etienne Lefrançois  1   2   3 , Victor Delanoue  4 , Samuel Morice  5 , Xavier Ravalec  1   2 , Marie Desclos-Theveniau  1   2   6
Affiliations
Case Reports

A Digital Approach for a Complete Rehabilitation with Fixed and Removable Prostheses: A Technical Procedure

Etienne Lefrançois et al. Dent J (Basel). .

Abstract

Background: The present article describes a step-by-step maximally digitalized workflow protocol with computer-aided design and computer-aided manufacturing (CAD/CAM) in partial-arch edentulous patients rehabilitated with fixed dental prostheses and removable partial dentures (FDPs and RPDs). Methods: Facial digitalization, intraoral scans, and functional mandibular movement recordings were used to create a 4D virtual patient on commercially available CAD software. The fixed components including post-and-cores, both metal-ceramic with extra-coronal attachment and monolithic zirconia crowns, and the RPDs were manufactured by computer numerical controlled direct milling. Results: This innovative digital approach using the virtual patient and the superimposition of interim RPDs fitted in the mouth has been used to provide fixed and removable rehabilitation to the patient without clinical complications with 2 years of follow-up. Conclusions: Within the limitations of this report, the developed combined prosthesis fabrication technique allowed optimization of the production by decreasing the clinical steps and laboratory procedures in partial-arch edentulous rehabilitated with FDPs and RPDs.

Keywords: CAD/CAM frameworks; digital dentistry; fixed partial denture; removable partial denture.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Initial panoramic radiography.
Figure 2
Figure 2
Digital view of the initial situation: (A) 3D images (TRIOS 4; 3Shape A/S) of maxillary, mandibular, and MMR captured by IOSs; (B) functional mandibular movements recording with the jaw motion tracer (MODJAW; MODJAW); and (C) facial scans (Bellus3D Face Camera Pro; Bellus3D) with AFT aligners.
Figure 3
Figure 3
(A) Creation of a 4D virtual patient by aligning digital data on CAD software (Exocad DentalCAD; exocad GmbH) and (B) occlusal and frontal views of digital waxing.
Figure 4
Figure 4
Digital impression of the entire root preparations without scan posts (Primescan; Dentsply Sirona): (A) external and (B) internal digital maxillary view of root canal preparations; (C) digital impression merged with digital waxing; and (D) post-and-cores digital design (3Shape Dental System; 3Shape).
Figure 5
Figure 5
Digital impressions (TRIOS 4; 3Shape A/S): (A) mandibular arch with prosthesis (relined RPD); (B) maxillary arch with prostheses (FDPs and RPDs relined); (C) maxillomandibular relationship recording (with all dentures); (D) maxillary arch with FDPs; (E) maxillary arch without prosthesis; (F) mandibular arch without prosthesis; (G) maxillary RPD scanning out-of-mouth; and (H) mandibular RPD scanning out-of-mouth.
Figure 6
Figure 6
Digital workflow based on a 4D virtual patient in a partial-arch edentulous patient rehabilitated with FDPs and RPDs. Numbers: chronology of matching. MMR: maxillomandibular relationship; JMT: jaw motion tracer.
Figure 7
Figure 7
Occlusal views of maxillary and mandibular definitive prostheses: (A,B) on the printed casts; (C,D) in clinical situation; and (E) frontal view of prostheses in clinical situation.
Figure 8
Figure 8
Follow-up at 2 years: (A) smile view; (B,C) occlusal views of maxillary and mandibular definitive prostheses; and (D) panoramic radiography.
See this image and copyright information in PMC

References

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