PMC9445565_01
Initial clinical situation - Abraded lower teeth and incorrect occlusal plane.
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The distal available teeth were medialized ( Figures 1 and 2). Upper frontal teeth covered completely the lower frontal teeth in central occlusion ( Figures 1 and 3).
Upper jaw at initial presentation.
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The distal available teeth were medialized ( Figures 1 and 2).
Central occlusion shown on initial presentation.
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Upper frontal teeth covered completely the lower frontal teeth in central occlusion ( Figures 1 and 3).
CBCT visualization - right and left TMJ.
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The left TMJ did not show deviations from the norm ( Figures 4 and 5).
Right TMJ condition with osteophyte.
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The left TMJ did not show deviations from the norm ( Figures 4 and 5).
Digital design - increased VDO.
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The stage was completed with digital optimization and determination of the working position of the lower jaw ( Figures 6 and 7).
Digital design - crowns.
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The stage was completed with digital optimization and determination of the working position of the lower jaw ( Figures 6 and 7).
Clinical situation after upper preparation with increased VDO.
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Briefly, transfer of the morphological planning for the upper dentition (crown strategy) and for the lower dentition (digital wax up strategy, pontics) was performed ( Figures 8 and 9).
Digital design on both jaws.
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Briefly, transfer of the morphological planning for the upper dentition (crown strategy) and for the lower dentition (digital wax up strategy, pontics) was performed ( Figures 8 and 9).
PMMA crowns on a model.
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TempML), which was cemented with temporary cement ( Prevision (Kulzer)). This construction was intended to remain in the patient's mouth throughout the period of adaptation and, if necessary, to be optimized ( Figures 10 and 11).
PMMA crowns cemented in the mount.
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TempML), which was cemented with temporary cement ( Prevision (Kulzer)). This construction was intended to remain in the patient's mouth throughout the period of adaptation and, if necessary, to be optimized ( Figures 10 and 11).
New position of the lower jaw.
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The splint was designed occlusively with balanced extended surfaces to maintain the occlusion, respectively the joint, in a stable position ( Figures 12- 15).
Splint design - lateral protrusion.
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The splint was designed occlusively with balanced extended surfaces to maintain the occlusion, respectively the joint, in a stable position ( Figures 12- 15).