PMC5587923_01
Digital panoramic tomography.
CRID2017-9378091.001.jpg
PMC5587923_01_CRID2017-9378091.001.jpg
fig1
The mandibular left first incisor had a labial apical fistula (Figures 1 and 2).
The digital periapical film of the left mandibular central incisor.
CRID2017-9378091.002.jpg
PMC5587923_01_CRID2017-9378091.002.jpg
fig2
The mandibular left first incisor had a labial apical fistula (Figures 1 and 2).
The right 2/3 removable overlay splint on the maxillary teeth.
CRID2017-9378091.003.jpg
PMC5587923_01_CRID2017-9378091.003.jpg
fig3
Continue to wear the right two-thirds part of the splint (Figures 3(a) and 3(b)) to support the transition relation, transfer the vertical dimension and the occlusal relation record as determined by the adapted trial treatment to the articulator, make the fixed reconstruction of the maxillary and mandibular posterior teeth with full porcelain crowns (Figure 4(a)), and operate conventional occlusal adjustment (Figure 4(b)).
The completed ceramic crowns of the left posterior teeth. The red marks indicate the centric occlusion; the blue marks show the protrusive occlusion.
CRID2017-9378091.004.jpg
PMC5587923_01_CRID2017-9378091.004.jpg
fig4
Continue to wear the right two-thirds part of the splint (Figures 3(a) and 3(b)) to support the transition relation, transfer the vertical dimension and the occlusal relation record as determined by the adapted trial treatment to the articulator, make the fixed reconstruction of the maxillary and mandibular posterior teeth with full porcelain crowns (Figure 4(a)), and operate conventional occlusal adjustment (Figure 4(b)).
The fabrication of the personalized anterior guidance disk and the diagnostic wax-up of the anterior teeth.
CRID2017-9378091.005.jpg
PMC5587923_01_CRID2017-9378091.005.jpg
fig5
Make an impression of the maxillary and mandibular dentition with the maxillary remaining two-thirds part of the splint worn in the mouth, mount on an articulator using a face bow, transfer the protrusive condylar guide inclination and the lateral condylar guide inclination using the anterior and lateral protrusive jaw position recording silicone rubber, and make a personalized anterior guidance disk with lightly cured resin (Figure 5(a)). According to this anterior guidance, make the maxillary and mandibular anterior teeth wax-up (Figure 5(b)) and then remove the anterior part of the rest of the splint.
Mounting the articulator with the maxillomandibular relations using relation recording silicone rubber alternately.
CRID2017-9378091.006.jpg
PMC5587923_01_CRID2017-9378091.006.jpg
fig6
According to the tooth preparation silicone guide to prepare the maxillary and mandibular incisors, make a polyether impression, make the temporary crowns, mount the maxillary and mandibular models in turn on the articulator (Figures 6(a)-6(d)), and eventually place the full ceramic crowns (Figure 7(a)).
The anterior teeth were treated using a fixed restoration according to the anterior guidance of the transitional occlusal splint. The red marks indicate the centric occlusion; the blue marks show the protrusive occlusion.
CRID2017-9378091.007.jpg
PMC5587923_01_CRID2017-9378091.007.jpg
fig7
According to the tooth preparation silicone guide to prepare the maxillary and mandibular incisors, make a polyether impression, make the temporary crowns, mount the maxillary and mandibular models in turn on the articulator (Figures 6(a)-6(d)), and eventually place the full ceramic crowns (Figure 7(a)). The maxillary and mandibular anterior fixed reconstruction retains the anterior guidance of the transitional splint (Figure 7(b)).
The fixed restoration of the right maxillomandibular posterior teeth according to the anterior guidance of the transitional overlay splint. The red marks indicate the centric occlusion; the blue marks show the protrusive occlusion.
CRID2017-9378091.008.jpg
PMC5587923_01_CRID2017-9378091.008.jpg
fig8
This step completes the ceramic crown restoration for the right maxillary and mandibular posterior teeth in accordance with the occlusal relationship (Figure 8).
Frontal and lateral views of the finished dental restoration.
CRID2017-9378091.009.jpg
PMC5587923_01_CRID2017-9378091.009.jpg
fig9
After 4-month follow-up, examination was done and the minor occlusion registration was checked; there was no other discomfort and the denture appearance and shape were improved (Figure 9).