J Dent Rehabil Appl Sci.  2023 Jun;39(2):96-103. 10.14368/jdras.2023.39.2.96.

Fabrication of maxillary complete denture and mandibular implant retained overdenture using CAD-CAM system and Monolithic disc: a case report

• Ro J
• Bang H
• Jang W
• Park C
• Lim HP
• Park S
• Yun KD

• KMID: 2549277
• DOI: http://doi.org/10.14368/jdras.2023.39.2.96

Abstract

Fabrication of dentures using CAD/CAM system has the advantage of reducing the number of patient visits and reducing errors during laboratory work. After the extraction of maxillary residual teeth, this patient changed to a completely edentulous state and the stability and retention of the existing mandibular complete denture were insufficient due to the absorption of the mandibular residual ridge, so the restoration of the mandibular implant retained overdenture and maxillary complete denture were planned. By digitizing the concept of BPS (Biofunctional prosthetic system) that uses the patient’s functional movement in closed mouth technique, the vertical dimension was taken by Gnathometer CAD and digital facebow transfer was performed using UTS CAD. In this case, fabrication of maxillary complete denture and mandibular implant-retained overdenture using monolithic disc and CAD/ CAM system demonstrated favorable denture retention, stability, and support and the patient is satisfied with improved functions and esthetic of dentures.

Keyword

CAD/CAM; monolithic disc; mandibular implant-retained overdenture

Figure

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  Fig. 1 Initial panoramic radiograph.

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  Fig. 2 Initial intraoral photographs. (A) Frontal view, (B) Maxillary occlusal view, (C) Mandibular occlusal view.

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  Fig. 3 Flow-chart of the treatment progress.

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  Fig. 4 Panoramic radiograph after insertion of two implants in the mandible.

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  Fig. 5 Existing vertical height transfer. (A) Existing vertical height, (B) Preliminary bite with centric tray.

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  Fig. 6 Digital facebow transfer using UTS CAD was performed arranging UTS-CAD parallel to the pupillary line and the alar tragus line.

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  Fig. 7 Centric relation was recorded using the gothic arch technique after setting the vertical dimension by attaching the Gnathometer M CAD to the individual tray (Gnathometer M CAD, Ivoclar Vivadent, Liechtenstein, Germany).

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  Fig. 8 After attaching the T-shaped resin index to the individual tray, a facial scan was acquired with a Thunk 3D Archer scanner, and facial scan and impression scan were superimposed in the ai based software that is 3Dme studio program (3Dme studio, Imagoworks Inc., Seoul, Korea).

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  Fig. 9 Artifical teeth were arranged on a virtual articulator and try-in dentures were designed in CAD software.

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  Fig. 10 Anterior view of the try-in dentures made by 3d printing.

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  Fig. 11 Monolithic disc (Ivotion, Ivoclar Vivadent, Schaan, Liechtenstein).

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  Fig. 12 Definitive completed dentures made by milling of monolithic disc. (A) Right lateral view, (B) Frontal view, (C) Left lateral view.

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  Fig. 13 Bilateral balanced occlusion reproduced on virtual articulator and real articulator. (A) Right lateral view on virtual articulator, (B) Left lateral view on virtual articulator, (C) Right lateral view on real articulator, (D) Left lateral view on real articulator.

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  Fig. 14 Superimposing the scan data of milling denture before clinical remounting and the scan data of milling denture after clinical remounting occlusion adjustment (3Dme studio, Imagoworks Inc., Seoul, Korea).

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  Fig. 15 Basal view of the mandibular implant-retained overdenture equipped with intermediate retention inserts (pink nylon).

Reference

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