J Korean Acad Prosthodont.  2019 Jul;57(3):280-287. 10.4047/jkap.2019.57.3.280.

Full mouth rehabilitation of a patient with severe tooth erosion with a digital crown lengthening guide

• Park Y
• Hong SJ
• Paek J
• Pae A
• Kim HS

• KMID: 2453783
• DOI: http://doi.org/10.4047/jkap.2019.57.3.280

Abstract

In the oral cavity, the teeth undergo wear and corrosion throughout their lives. Progressive and constant tooth wear is a natural phenomenon of aging, but wear and corrosion due to specific factors are pathological factors. It can cause pathological damage of the occlusal surface, aesthetic problems, dimensional loss and jaw joint disorders. This case is a 26-year-old female patient with general tooth abrasion and erosion on the entire dentition. Diagnostic wax-up was fabricated based on the information including digital facial analysis, physiological stabilization, and evaluation of anterior crown length. Through the digital analysis, the necessary guides for crown lengthening were prepared and the mastication function and esthetics were evaluated by using temporary crowns. Definitive prosthesis was fabricated with the zirconia restorations. The results were satisfactory when they were observed 3 months of follow-up.

Keyword

Tooth erosion; Crown lengthening procedure; Digital guide

MeSH Terms

Adult
Aging
Corrosion
Crown Lengthening*
Crowns*
Dentition
Esthetics
Female
Follow-Up Studies
Humans
Jaw
Joints
Mastication
Mouth Rehabilitation*
Mouth*
Prostheses and Implants
Tooth Abrasion
Tooth Erosion*
Tooth Wear
Tooth*

Figure

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  Fig. 1 Preoperative extraoral photographs. (A) Frontal view, (B) Lateral view, (C) Panoramic view.

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  Fig. 2 Severe erosion on entire dentition and unesthetic smile are showed on the photographs. (A) Occlusal view of maxilla, (B) Lateral view (right side), (C) Frontal view, (D) Lateral view (left side), (E) Unaesthetic smile, (F) Occlusal view of mandible.

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  Fig. 3 Diagnostic wax-up. (A) Occlusal view of maxilla, (B) Lateral view (right side), (C) Frontal view, (D) Lateral view (left side), (E) Diagnostic wax-up using template system, (F) Occlusal view of mandible.

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  Fig. 4 Crown lengthening procedure (CLP) guide. (A) Facial scanning of smile, (B) Design of CLP guide, (C) CLP guide, (D) Superimposition of facial scan and CLP model, (E) Occlusal view of CLP guide, (F) Frontal view of CLP guide.

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  Fig. 5 Temporary prosthesis. (A) Occlusal view of maxilla, (B) Lateral view (right side), (C) Frontal view, (D) Lateral view (left side), (E) Lateral view (right side, lateral movement), (F) Occlusal view of mandible, (G) Lateral view (left side, lateral movement).

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  Fig. 6 (A) Frontal view of facial photograph (rest), (B) Frontal view of facial photograph (smile).

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  Fig. 7 Design of individual tooth tray used temporary restorations.

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  Fig. 8 (A) Definitive restorations of maxilla, (B) Definitive restorations of mandible.

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  Fig. 9 Definitive restoration. (A) Occlusal view of maxilla, (B) Lateral view (right side), (C) Frontal view, (D) Lateral view (left side), (E) Lateral view (right side, lateral movement), (F) Occlusal view of mandible, (G) Lateral view (left side, lateral movement).

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  Fig. 10 After treatment. (A) Frontal view of facial photograph (rest), (B) Frontal view of facial photograph (smile), (C) Panoramic view of definitive restorations.

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