Clinical Report
Integrating conventional and CAD/CAM digital techniques for establishing canine protected articulation: A clinical report

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Abstract

Canine protected articulation is widely accepted for patients requiring extensive oral rehabilitation. Computer-aided design and computer-aided manufacturing (CAD/CAM) restorations have been primarily designed in occlusion at the maximum intercuspal position. Designing a virtual articulator that is capable of accepting excursive occlusal records and duplicating the mandibular movements is a challenge for CAD/CAM technology. Modifying tooth shape using composite resin trial restorations to produce esthetic results and later scanning the modified teeth to create milled crowns is becoming a popular use of the CAD/CAM technology. This report describes a technique that combines conventional and CAD/CAM prosthodontic techniques for milling crowns for canine teeth that are designed to establish or improve canine protected articulation. This technique involves designing and fabricating interim restorations based on diagnostic waxing, scanning the designs intraorally, and storing them in software as pretreatment digital records. The scanned designs are then applied to the digital representation of the prepared teeth to fabricate the definitive restorations.

Section snippets

Clinical Report

A 62-year-old white man in good health and no significant medical history presented complaining of pain, sensitivity, and gingival inflammation in the right and left maxillary canine teeth. Endodontic consultation revealed only reversible hyperemia due to recurrent caries on the composite resin restorations on both teeth. His dental history revealed that 4 years previously the maxillary central incisor teeth had been endodontically treated and that 4 lithium disilicate crowns had been made for

Discussion

This article presents a technique for accurately establishing canine protected articulation using CAD/CAM technology. This technique enables the clinician to transfer designs made on an articulator conveniently and accurately to the digital software. The technique can be used with any CAD/CAM system that accepts a pre-preparation record, applying it later to the prepared tooth. In agreement with many authors, vacuum form matrices proved to be an accurate method of duplicating the diagnostic

Conclusions

This article describes a technique that produces accurate CAD/CAM restorations milled according to a specific occlusal scheme. Integrating the use of a physical articulator into CAD/CAM technology is an easy step that produces accurate results.

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