PMC6874995_01
Fontal view of teeth in occlusion before treatment.
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The patient's plane of occlusion was not harmonious, and the lack of a stable posterior occlusion led to moderate wear of her remaining anterior teeth and a collapse in her vertical dimension of occlusion which were not addressed with the previous fixed partial restorations on teeth #14, 13, and 11 (Figures 1-3).
Panoramic radiograph before treatment.
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The patient's plane of occlusion was not harmonious, and the lack of a stable posterior occlusion led to moderate wear of her remaining anterior teeth and a collapse in her vertical dimension of occlusion which were not addressed with the previous fixed partial restorations on teeth #14, 13, and 11 (Figures 1-3).
A view of mounted diagnostic casts.
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The patient's plane of occlusion was not harmonious, and the lack of a stable posterior occlusion led to moderate wear of her remaining anterior teeth and a collapse in her vertical dimension of occlusion which were not addressed with the previous fixed partial restorations on teeth #14, 13, and 11 (Figures 1-3).
Clinical remount of interim prostheses.
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An interim maxillary complete denture and mandibular partial denture was delivered immediately after the extraction of the remaining maxillary teeth and mandibular incisors (Figure 4).
Wax-up for PFM crowns on teeth #21, 22, 27, 29, and 31.
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Then, the maxillary cast was removed from the upper member of the articulator, and the guide plane jig for compensating curve (2.5D Setup Template, Ivoclar Vivadent, Schaan, Liechtenstein) was inserted. The simulation of tooth preparations was made on the mandibular cast to ideal dimensions before the wax-up was made (Figure 5).
Pick-up impression of metal copings made.
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A coping pick-up impression was made with the PVS impression material (Figure 6) and poured with stone (Microstone, Whip Mix Corp.) (Figure 7).
Metal copings with their exact spatial relations obtained on the master cast.
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A coping pick-up impression was made with the PVS impression material (Figure 6) and poured with stone (Microstone, Whip Mix Corp.) (Figure 7).
Final mandibular tooth arrangement made using the 2.5D guide plane.
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Then, porcelain was built on the copings following the 2.5D template and the maxillary tooth arrangement was also made according to the same template (Figure 8).
View of final tooth arrangement made.
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The metal framework and the crowns were tried in together, and the final tooth arrangement was made with the same template (Figure 9).
View of patient's smile at delivery.
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At delivery, minimal occlusal adjustments were done intraorally to achieve lingualized occlusion with balanced centric and eccentric contacts (Figure 10).