J Dent Rehabil Appl Sci.  2023 Sep;39(3):168-175. 10.14368/jdras.2023.39.3.168.

Using treatment denture and digital technology in patient with unstable mandibular movement: a case report

• Oh E
• Jang W
• Park C
• Yun K
• Lim HP
• Park S

• KMID: 2549283
• DOI: http://doi.org/10.14368/jdras.2023.39.3.168

Abstract

Long-term use of inappropriate prosthesis often results in habitual closure or irregular mandibular movements. In that case, guide to the stable centric position is difficult. Therefore, by using a treatment denture, the muscles and TMJ should be stabilized and the jaw relation should be acquired with the treatment position. Compared to the conventional method, digital technology in fabrica-tion complete denture has the advantage of reproducing a stable tooth arrangement in cases of difficult tooth alignment, minimiz-ing laboratory errors and reducing denture fabrication time. Therefore, in this case, the final denture was fabricated by digitally re-producing the stable treatment position, vertical dimension, and lip support with a treatment denture, and satisfactory results were obtained.

Keyword

CAD/CAM; treatment denture; unstable mandibular movement

Figure

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  Fig. 1 Initial radiograph. (A) Panoramic radiograph, (B) TMJ radiograph. flattened condyle head.

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  Fig. 2 Extraoral photograph. It shows mandibular deviation to right side.

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  Fig. 3 Intraoral photographs (Post-extraction). (A) Maxillary occlusal view, (B) Frontal view, (C) Mandibular occlusal view.

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  Fig. 4 VD and CR registration. (A) Gothic arch tracing, (B) Mounted in the articulator.

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  Fig. 5 Fabrication of treatment denture. (A) Mixed talcum powder and self cure resin, (B) Flat occlusal table treatment denture.

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  Fig. 6 Indentation marks on the flat occlusal table of treatment denture (A) First time delivery. It shows spread mark, (B) 4 weeks after delivery. It shows repeatable mark.

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  Fig. 7 A series of Processes to obtain definitive digital cast. (A) Functional impressions taken with the treatment dentures, (B) Inverting of denture impression phase using CAD software(Meshmixer, Autodesk Inc, San Jose, USA), (C) Determination of jaw relation with treatment denture, (D) Definitive digital cast.

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  Fig. 8 Digital facebow transfer with UTS CAD. (A) Parallel to the camper’s plane (CE: -3.0), (B) Parallel to the interpupillary line (BP: -1.0).

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  Fig. 9 Digital mounting on the virtual articulator. (A) Determination of occlusal plane with treatment denture, (B) Teeth arrangement on the tissue surface, (C) Facial scan data as a reference of teeth arrangement.

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  Fig. 10 3D printed trial denture. (A) Arrangement with anatomical teeth, (B) Arrangement with nonanatomical teeth, (C) Occlusal surface of anatomical teeth, (D) Occlusal surface of nonanatomical teeth.

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  Fig. 11 Definitive denture. (A) Right lateral view, (B) Frontal view, (C) Left lateral view, (D) Facial appearance after delivery.

Reference

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