J Dent Rehabil Appl Sci.  2024 Nov;40(4):313-321. 10.14368/jdras.2024.40.4.313.

Oral rehabilitation in a patient with severe wear due to Sjögren syndrome: a case report

• Park NK
• Kim MS
• Lee JH
• Lee JI
• Lee SK

• KMID: 2562775
• DOI: http://doi.org/10.14368/jdras.2024.40.4.313

Abstract

In patients with Sjögren syndrome, decreased salivary flow result in reduced buffering capacity, which leads to the gradual erosion of enamel and significant tooth wear in both anterior and posterior teeth. The tooth wear often causes the loss of anterior and lateral guidance, occlusal disharmony, and insufficient space for prosthetic restorations, leading to functional and esthetic challenges, as well as complex occlusal issues. To address these issues, applying standardized cusp angles can help achieve long-term stability in occlusal contacts, allowing for a functional and stable occlusion with minimal adjustments during centric and eccentric movements. This case report presents a patient with Sjögren syndrome who exhibited severe wear in the maxillary and mandibular anterior and posterior teeth. Through prosthetic rehabilitation using standardized cusp angles, occlusal stability was improved, and esthetic outcomes were achieved, highlighting the effectiveness of this approach in restoring both function and esthetics.

Keyword

Sjögren syndrome; tooth attrition; occlusal guidances; double scan technique

Figure

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  Fig. 1 Panoramic radiograph before treatment.

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  Fig. 2 Intraoral photograph before treatment. (A) Upper occlusal view, (B) Right lateral view, (C) Frontal view, (D) Left lateral view, (E) Lower occlusal view.

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  Fig. 3 Condition 1 setting. (A) Articulator adjustment for condition 1, (B, C) Diagnostic wax-up of lower right and left posterior.

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  Fig. 4 Condition 2 setting. (A) Articulator adjustment for condition 2 of mutually protected occlusion, (B) Diagnostic wax-up of anterior teeth.

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  Fig. 5 Intraoral photograph of provisional restoration state. (A) Right lateral view, (B) Left lateral view, (C) Right lateral view of canine guidance, (D) Left lateral view of canine guidance.

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  Fig. 6 Final impression and definitive prosthesis of posterior teeth. (A, D) Final impression, (B, E) Superimposition, (C, F) Definitive prosthesis of posterior teeth.

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  Fig. 7 Final impression and definitive prosthesis of anterior teeth. (A) Final impression, (B) Superimposition, (C) Full contour monolithic zirconia crown.

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  Fig. 8 Intraoral photograph of definitive restoration state. (A) Upper occlusal view, (B) Right lateral view, (C) Frontal view, (D) Left lateral view, (E) Lower occlusal view.

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  Fig. 9 Panoramic radiograph after treatment.

Reference

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