Complete functional and esthetic rehabilitation using full digital workflow and equipment

Abstract

A 66-year-old male patient applied for dental rehabilitation due to esthetic and functional problems. Decrease of chewing ability and inferior esthetics were detectable due to his worn dentition and old PFM restorations. After taking photos and intraoral scans, a complete digital functional registration was recorded with the MODJAW system. By recording all the important functional motions, a new Vertical Dimension was selected within the patient's centric relation. Dental design for creating a digital waxup was done in exocad and 3Shape Dental Designer software using all the recorded patient information. The final design was physically created by 3D printing and transferred to the patient's mouth for functional and esthetic verification. After acceptance of the pre-design, removal of old prosthetics and precisional preparation were done and followed with digital impression taking. Final restoration shapes were copied from original wax up, and milling of the permanent restorations was done using IPS e.max ZirCAD Multi A1 material in Ivoclar PM7 milling machine. Staining and glazing of the restorations were created from IPS Ivocolor. Cementation was done adhesively, using SpeedCEM Plus self-adhesive, selfcuring resin cement. At the delivery stage a smile makeover was completed for the patient including 24 single-unit crowns and a three unit bridge. Vertical dimension was elevated and esthetics were improved. Digital technology using functional motion registration and 3D printed trials is a predictable way to securely apply full mouth rehabilitation workflows.