J Dent Rehabil Appl Sci.  2015 Sep;31(3):273-282. 10.14368/jdras.2015.31.3.273.

Prosthetic rehabilitation for a patient with CO-MI discrepancy

• Choo SS
• Heo YH
• Cho LR
• Park CJ

• KMID: 2180030
• DOI: http://doi.org/10.14368/jdras.2015.31.3.273

Abstract

Centric occlusion-maximum intercuspation (CO-MI) discrepancy is one of main causes of evoking premature contact and resultant mandibular shift. These non-physiological conditions can induce temporomandibular disease, periodontitis, and non-carious cervical lesion. Therefore, if CO-MI discrepancy exists in patients who need extensive prosthetic rehabilitation, it must be corrected and then physiological occlusion must be restored. This report describes the treatment procedure of removing CO-MI discrepancy and prosthetic rehabilitation in a patient with 3.5 mm discrepancy, multiple caries and periodontitis. Proper mandibular position and modified opening & closing movement were confirmed by ARCUSdigma II and transcranial radiograph.

Keyword

centric relation; maximum intercuspal position; centric slide; prosthetic rehabilitation

MeSH Terms

Centric Relation
Humans
Periodontitis
Rehabilitation*

Figure

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  Fig. 1 Radiographic evaluation: severe bone loss and secondary caries on upper left quadrant.

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  Fig. 2 Intraoral examination: multiple teeth loss, gingival recession and midline discrepancy.

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  Fig. 3 (A) right mandibular shift on maximum intercuspation, (B) guided centric relation.

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  Fig. 4 Vertical dimension evaluation.

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  Fig. 5 (A) initial examination, (B) corrected mandibular position using 1st provisional prosthesis.

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  Fig. 6 Re-evaluation for prosthetic and occlusal design after implant placement and teeth preparation.

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  Fig. 7 Stable centric and lateral occlusal contact establishment using 2nd provisional prosthesis.

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  Fig. 8 (A) Full-contour wax-up, (B) Cut-back, (C) Metal coping fabrication, (D) Try-in.

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  Fig. 9 Definitive prosthesis showing harmonized occlusal relationship.

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  Fig. 10 Panoramic radiograph at 3 month follow-up.

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  Fig. 11 Transcranial view of right mandibular condyle. (A) At initial examination, (B) During provisionalization, (C) After Wearing definitive prosthesis.

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  Fig. 12 Opening and closing path traced by ARCUSdigma II (A) Frontal view on initial examination, (B) Frontal view after definitive prosthesis delivery, (C) Sagittal view on initial examination, (D) Sagittal view after definitive prosthesis delivery.

Reference

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