J Dent Rehabil Appl Sci.  2024 Nov;40(4):257-267. 10.14368/jdras.2024.40.4.257.

Conical double crown removable partial denture using facial scan and digital diagnostic template

• Son SM
• Seo MK
• Ko KH
• Huh YH
• Park CJ
• Cho LR

• KMID: 2562770
• DOI: http://doi.org/10.14368/jdras.2024.40.4.257

Abstract

Partially edentulous patients with a crossed occlusion have poor denture support, retention, and stability. Moreover, residual abutments showed a poor prognosis due to denture rotation. The use of a conical double crown removable partial denture to establish proper horizontal and vertical interocclusal relationships, it can establish a stable occlusal plane and occlusal contacts providing a sufficient restorative space and a favorable functional and aesthetic outcome. In this case, a patient with an anteriorposterior crossed occlusion with mandibular prognathism and no occluding teeth in habitual centric position was treated with a conical double crown removable partial denture. After diagnostic cast analysis and digital diagnosis, provisional prosthesis templates were fabricated. It was possible to intuitive and appropriate vertical dimension determination and esthetic evaluation were performed. Definitive prosthesis with proper function and aesthetics can be fabricated by the digital and conventional treatment process.

Keyword

crossed occlusion; conical double crown removable partial denture; digital diagnosis; occlusal vertical dimension; oral rehabilitation

Figure

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  Fig. 1 Initial panoramic radiograph.

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  Fig. 2 Extraoral photographs. (A) Frontal view, rest, (B) Frontal view, smile, (C) Lateral view.

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  Fig. 3 Pre-operative intraoral photographs. (A) Maxillary occlusal view, (B) Right lateral view, (C) Frontal view, (D) Left lateral view, (E) Mandibular occlusal view.

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  Fig. 4 Diagnostic cast analysis in tentatively increased occlusal vertical dimension. (A) Maxillary occlusal view, (B) Right lateral view, (C) Frontal view, (D) Left lateral view, (E) Mandibular occlusal view.

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  Fig. 5 Vertical dimension evaluation. (A) Facial appearance evaluation, (B) Interocclusal rest distance evaluation (centric occlusion), (C) Interocclusal rest distance evaluation (physiologic rest position).

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  Fig. 6 Interim denture fabrication. (A) Interocclusal record, (B) Interim denture.

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  Fig. 7 Digital diagnostics using face scans. (A) Face scan, (B) Model aligning, (C) +5 mm increased vertical dimension, (D) +6 mm increased vertical dimension. (E) +7 mm increased vertical dimension.

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  Fig. 8 Evaluation of vertical dimension and facial esthetics using resin templates. (A) Resin template, (B) +5 mm increased vertical dimension, (C) +6 mm increased vertical dimension, (D) +7 mm increased vertical dimension.

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  Fig. 9 Clinical application of resin templates. (A) Guide for abutment preparation, (B) Recording interocclusal relationship for inner crown fabrication.

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  Fig. 10 Extra-oral evaluation in wax denture try-in. (A) Frontal view, rest, (B) Frontal view, smile, (C) Lateral view.

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  Fig. 11 Intraoral photograph after the placement of definitive restorations. (A) Working side during right lateral excursion, (B) Maxillary occlusal view, (C) Non-working side during right lateral excursion, (D) Left lateral view at centric occlusion, (E) Frontal view at centric occlusion, (F) Right lateral view at centric occlusion, (G) Non-working side during left lateral excursion, (H) Mandibular occlusal view, (I) Working side during left lateral excursion.

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  Fig. 12 (A) Conventional denture, (B) CAD-CAM printing denture, (C) Limitation in clasp adjustment.

Reference

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