Abstract
The objective of this case report was to describe the clinical sequence for occlusal vertical dimension (OVD) recovering with the manufacture of removable partial dentures (RPD) produced by computer-aided design and rapid prototyping. The patient presented to the Dentistry Department of the Federal University of Rio Grande do Norte reporting dissatisfaction with the superior RPD. At clinical investigation, a fracture in the minor connector and support at the region of tooth 15 was observed, in addition to severe OVD loss. In this case, after obtaining correct OVD, four more sessions were necessary for RPD fabrication. In the first appointment, intraoral scanning was performed to generate STL files used for path of insertion determination in the CAD software. The need for a guide plane on tooth 15 was observed, thus a preparation guide was designed and 3Dprinted to aid axial tooth reduction. At the second visit, after mouth preparation, another intraoral scanning was performed to acquire virtual working models. The RPD framework was designed and 3D printed in a castable resin pattern and invested for cobalt-chromium alloy melting. In the third visit, clinical evaluation of the framework and teeth and artificial gingiva colors selection were performed. The articulated models were then 3D printed, enabling pre-fabricated teeth to be assembled and acrylized. On the fourth appointment, RPD was installed and the patient received routine instructions. In this sense, the use of CAD/CAM technologies presented as a valuable tool to enhance restoration of OVD by the manufacturing of RPD.
Highlights
Digital technology and its application to the design and fabrication of partial and complete-arch prosthesis is advancing rapidly
The objective of this case report was to describe the clinical sequence for occlusal vertical dimension (OVD) recovering with the manufacture of removable partial dentures (RPD) produced by computer-aided design and rapid prototyping
After obtaining correct OVD, four more sessions were necessary for RPD fabrication
Summary
Digital technology and its application to the design and fabrication of partial and complete-arch prosthesis is advancing rapidly. Despite the numerous advantages, the currently practiced CAD-CAM methods for RPDs still have limitations, with regard to dentomucosupported RPDs (Kennedy class I and II framework). This occurs because the impressions are taken with the inclusion of soft tissue, such as a partially edentulous ridge, as well as the residual teeth (Hayama, et al, 2018). The posterior steps of manufacturing should provide good accuracy and excellent mechanical properties (Koutsoukis, et al, 2015). This report describes a clinical sequence used in the fabrication of a removable partial denture (RPD) involving large OVD losses with a digital workflow (intraoral scanning and rapid prototyping for metallic framework)
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