J Korean Acad Prosthodont.  2016 Jul;54(3):291-297. 10.4047/jkap.2016.54.3.291.

Rehabilitation using twin-stage method for a Sjögren's syndrome patient with severe discoloration and attrition on upper and lower anterior teeth

• Lee SK
• Yang HS
• Park SW
• Lim HP
• Yun KD

• KMID: 2344870
• DOI: http://doi.org/10.4047/jkap.2016.54.3.291

Abstract

Patients with Sjögren's syndrome usually suffer from teeth discoloration and attrition due to xerostomia. If the anterior teeth are badly worn, problems such as loss of anterior guidance, occlusal disharmony, and limited space for restoration may occur. However, ideal occlusion is obtained in both centric and eccentric relation by regaining the disocclusion of the posterior teeth through the anterior and lateral guidance using twin-stage method. In this case, rehabilitation was performed for a Sjögren's syndrome patient with maxillary and mandibular incisor's severe attrition and teeth discoloration by using twin-stage method.

Keyword

Sjögren's syndrome; Twin-stage method; Double scanning technique; Computer aided design-computer aided manufacturing (CAD-CAM)

MeSH Terms

Dental Occlusion
Humans
Methods*
Rehabilitation*
Tooth*
Xerostomia

Figure

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  Fig. 1. Initial panoramic radiograph.

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  Fig. 2. Initial intraoral photographs. Anterior teeth with discoloration and attrition. (A) Frontal view, (B) Maxillary occlusal view, (C) Mandibular occlusal view.

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  Fig. 3. Twin-stage method on working cast. (A) Working model with separate die mounted on the Twin-Hoby articulator, (B) Maxillary working model, (C) Mandibular working model.

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  Fig. 4. Articulator adjustment values for mutually protected articulation of condition 1. (A) Working model with die separated, (B) Lateral wing angle 10°, (C) Sagittal inclination 25° .

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  Fig. 5. Articulator adjustment values for mutually protected articulation of condition 2. (A) Diagnostic wax pattern, (B) Lateral wing angle 20°, (C) Sagittal inclination 45° .

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  Fig. 6. Teeth preparation for CAD-CAM provisional restoration. (A) Abutment preparation, (B) Fabrication of 1st provisional restoration with vacuum sheet, (C, D) Impression for double scanning technique.

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  Fig. 7. Double scanning technique for provisional restoration. (A) Abutment scanning, (B) Superimposition, (C) 2nd provisional restoration, (D) 2nd provisional restoration delivery.

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  Fig. 8. Double scanning technique for definitive prosthesis. (A, B, C) Final impression, (D, E) superimposition, (F) Full contour monolithic zirconia crown.

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  Fig. 9. Definitive restoration. (A) Right lateral view at canine guidance, (B) Frontal view, (C) Left lateral view at canine guidance.

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  Fig. 10. Patient's profile. (A) Non-esthetic profile at first visit, (B) Esthetic profile after definitive prosthesis placement.

Reference

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