J Korean Acad Prosthodont.  2017 Oct;55(4):410-418. 10.4047/jkap.2017.55.4.410.

Full-mouth rehabilitation in an amelogenesis imperfecta patient with anterior open bite using CAD/CAM system

• Lee SH
• Yi YJ
• Jo DW

• KMID: 2393913
• DOI: http://doi.org/10.4047/jkap.2017.55.4.410

Abstract

Amelogenesis imperfecta characterized as abnormally formed enamel is caused by a defect of unique group of genes. Patients affected by this disease might have difficulties in social and psychological aspects due to non-esthetic teeth as well as functional problems caused by enamel detachment and tooth wear from their early ages. Adult patients with amelogenesis imperfecta can be treated with full-mouth restorations, which make functional and esthetic rehabilitations of severely worn tooth. However, the anterior open bite and lack of occlusal clearance for posterior teeth restorations due to compensatory extrusion are the intervening factors in the prosthetic treatment. Therefore, the determination of anterior tooth lengths, vertical dimension, and anterior guidance should be set carefully. Recently, computer-aided design and computer-aided manufacturing (CAD/CAM) techniques help systematic approaches and enable dentists to reduce time-consuming procedures in the diagnosis and treatment of full-mouth rehabilitation. This case report demonstrates the successful full mouth rehabilitation using a CAD/CAM system in a young adult patient with amelogenesis imperfecta and anterior open bite.

Keyword

Amelogenesis imperfecta; Full mouth restoration; Anterior open bite; Computer-aided design and computer-aided manufacturing

MeSH Terms

Adult
Amelogenesis Imperfecta*
Amelogenesis*
Computer-Aided Design
Dental Enamel
Dentists
Diagnosis
Humans
Mouth Rehabilitation
Open Bite*
Rehabilitation*
Tooth
Tooth Wear
Vertical Dimension
Young Adult

Figure

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  Fig. 1 Preoperative intraoral view showing generalized tooth wear and anterior open bite. (A) Occlusal view of maxilla, (B) Right lateral view, (C) Frontal view, (D) Left lateral view, (E) Occlusal view of mandible.

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  Fig. 2 Facial view.

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  Fig. 3 Panoramic view.

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  Fig. 4 Customized anterior guidance table.

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  Fig. 5 Diagnostic wax-up.

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  Fig. 6 1st provisional restorations. Approximate occlusal plane and tooth contour, patient's adaptation to occlusal change, disappearance of hypersensitivity, and occlusal clearance for posterior restoration were evaluated through 1st provisional restorations. (A) Extraoral photo, (B) Intraoral photo.

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  Fig. 7 CAD/CAM procedure for 2nd provisional prostheses. (A) Incisal edges and occlusal plane evaluation on virtual model, (B) Frontal view of maxillary crowns.

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  Fig. 8 2nd provisional restorations.

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  Fig. 9 Working cast and die.

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  Fig. 10 Definitive restorations. (A) Frontal view, (B) Protrusive movement, (C) Right lateral excursion, (D) Left lateral excursion.

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  Fig. 11 One year after definitive restorations. (A) Frontal view, (B) Protrusive movement, (C) Right lateral excursion, (D) Left lateral excursion.

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