Fully digital workflow of occlusal reconstruction treatment in a patient with congenital dentition defects.

OBJECTIVE: Occlusal reconstruction is a critical intervention for patients with dental hard tissue defects, temporomandibular joint (TMJ) disorders, and jaw position abnormalities. Clinical efficiency and outcomes of these procedures have improved with advances in digital technologies. This case report aims to illustrate a comprehensive digital workflow for occlusal reconstruction in a patient with congenital dentition defects, emphasizing the application of digital technologies to enhance treatment outcomes. CLINICAL CONSIDERATIONS: A 28-year-old woman with previously installed porcelain-fused-to-metal bridge restorations presented with a fractured prosthesis and TMJ symptoms. A multidisciplinary approach was adopted involving the use of digital facebow, intraoral scanners, digital smile design, and CAD/CAM technologies. The process included the extraction of defective restorations, temporary restorations to refine jaw position, and final permanent restorations. The digital workflow facilitated precise diagnostics and treatment, culminating in the successful installation of permanent restorations. Regular follow-ups at one- and three-months post-treatment confirmed stable occlusal function and high patient satisfaction. CONCLUSIONS: This case report showcases the potential of multiple digital technologies to streamline complex dental treatments and achieve high-quality results. CLINICAL SIGNIFICANCE: The integration of digital technologies in occlusal reconstruction treatments offers significant benefits in terms of precision, patient comfort, and esthetic outcomes.

Digital-assisted multidisciplinary treatment for complex occlusal rehabilitation: an 18-month follow-up case report.

BACKGROUND: This case report highlights the importance of standardized and fully digital sequential treatment in complex occlusal rehabilitation cases. To fully resolve the patient's dental needs, such cases often require multidisciplinary interventions including periodontal therapy, endodontic treatment, anterior esthetics, implant restoration, and prosthetic rehabilitation. A fully digital workflow (including facial scanners, intraoral scanners, jaw motion tracking systems, virtual articulators, and computer-aided design software) streamlined the complex treatment, enhancing workflow simplicity, efficiency, visibility, and precision. CASE PRESENTATION: The patient presented with decreased chewing efficiency of the upper and lower prostheses, along with unsatisfactory esthetic appearance of the anterior teeth. After physical examination and radiological assessment, this complex occlusal rehabilitation case required periodontal therapy, anterior esthetic enhancement, implant restoration, and fixed prosthetic rehabilitation. Therefore, a fully digital workflow was adopted. Full-crown prostheses were placed on teeth 13, 23, and 34; a fixed bridge encompassed positions 32 to 42, and single implant crowns were placed on teeth 35 and 36. Implant-supported fixed bridges were constructed for teeth 12 to 22 and 44 to 46, anchored by implants at teeth 12, 22, 44, and 46. All definitive prostheses were fabricated from zirconia ceramics, chosen for their durability and esthetic characteristics. Finally, restorations with satisfactory esthetic and functional characteristics were seated, preserving the tooth and its supporting structures. During treatment and follow-up, the T-scan occlusal analysis system was utilized to continuously monitor and guide the adjustment of occlusal distribution across the patient's dental arches. After 18 months, the patient remains satisfied with the definitive restorations. CONCLUSIONS: This report is intended to help dentists understand and implement standardized and fully digital workflows during the management of complex occlusal rehabilitation cases; it may also facilitate harmonious integration of esthetic and functional characteristics.

[Correlation of TMJ structures and craniocervical area position in partial dental loss]. / Osobennosti vzaimootnosheniia polozheniia strukturnykh élementov visochno-nizhnecheliustnogo sustava i kraniotservikal'noi oblasti pri defektakh zubnykh riadov.

The purpose of the study was to determine the correlation features in position of the TMJ and the atlantoaxial compound in presence of dentition defects. The study included 20 patients (10 males and 10 females) aged 37 to 59 years with mandible terminal dentition defects. The comparison group included 20 patients of men and women equally, aged from 18 to 29 years with intact dentition. All patients were diagnosed with CT scan of the maxillofacial area, including the craniovertebral zone. In the analysis of the TMJ, the ratio of bone structures were determined by studying the CT scan in sagittal plane. The position of the elements of the atlantoaxial compound were evaluated on CT scan in frontal and transversal plane along the distance from the lateral masses of the CI vertebrae to the dens CII process. In persons with one-sided terminal dentition defect any changes of the position of the TMJ elements were not determined except for the right L1 parameter (8.91±0.45 mm and 6.8±0.77 mm, respectively, p=0.020). At the same time, the L1 distance on the left significantly changed to 6.86±0.40 mm relative to the comparison group (8.21±0.77 mm, p=0.030). In contrast to the ratio of the bony structures of the TMJ on the analysis of the craniocervical zone we determined the differences in the relationships of all elements of the atlantoaxial compound. The asymmetry index of CI-CII in the study group was 1.12±0.15 mm, in the comparison group 0.1±0.02 mm, p=0.001. The correlation analysis of the investigated structures showed different variants of the relation (direct and inverse) between the L1, L5 parameters of the TMJ and the distance from the lateral masses CI to dens CII. The structures of the TMJ in the presence of dentition defects remain practically unchanged and are more stable, it can be assumed that the primary link which undergo the changes considering the relationship between bone structures is the atlantoaxial junction.

Peri-implant crevicular fluid SIRT1 levels decrease in patients with peri-implant inflammatory: A prospective observational study.

BACKGROUND: A dental Implant is a prosthetic device made of alloplastic materials implanted into the bone to provide retention and support for a dental prosthesis. Sirtuin1 (SIRT1) molecule, a nicotinamide adenine dinucleotide (NAD)-dependent histone deacetylase, regulates a variety of physiological and pathological processes, including oxidative stress, metabolism, cell proliferation, cell differentiation, inflammatory, and apoptosis. We explored whether the expression of SIRT1 correlates in patients receiving implants with peri-implant mucositis (PIM) and peri-implantitis (PI) in comparison to patients with healthy peri-implant area (PIH). METHODS: A number of 198 patients with dentition defects were enrolled in the study after their implants were functional for at least 6 months. All 198 subjects were divided into 3 groups: 1) control patients with PIH healthy implants; 2) patients with PIM mucositis; and 3) patients with PI implantitis. To distinguish these three groups, peri-implant crevicular fluid (PICF) was collected by inserting a sterile paper strip into the gap around the implant and the levels of SIRT1 and cytokines were measured by the enzyme linked immunosorbent assay (ELISA). Demographic and clinical data included age, sex, Body Mass Index (BMI), probing depth (PD), plaque index (PLI), bleeding on probing (BOP), oral health impact profile (OHIP-14), history of periodontitis and the use time of implants. RESULTS: The PD, PLI, OHIP-14 evaluation scores in patients with periodontitis of PIM mucositis and PI implantitis were all significantly higher than in patients with PIH healthy implants. Overall, the SIRT1 levels in PICF of the PIM and PI patients were significantly lower than of the PIH patients. In comparison with PIM patients, SIRT1 levels of the PI patients were remarkably lower than the PIH patients. Pearson's analysis showed that SIRT1 levels were negatively correlated with levels of interleukin (IL)-6, C-reactive protein (CRP) and IL-1ß in patients with PIM and PI. We suggest that SIRT1 levels could serve as a potential diagnostic biomarker of PI or PIM. The PICF levels of SIRT1, CRP, IL-6, IL-1ß and the history of periodontitis were the risk factors for patients with peri-implant inflammatory process. CONCLUSION: The measurement of SIRT1 expression in PICF may serve as a biomarker for the ongoing inflammatory process in patients with dental implants. The low SIRT1 levels correlated with PI implantitis and PIM mucositis as well as the elevated levels of pro-inflammatory cytokines (CRP, IL-6 and IL-1ß).

Dental implant restoration for dentition defects improves clinical efficacy, masticatory function and patient comfort.

OBJECTIVE: The aim of this study is to demonstrate if dental implant restoration can improve the clinical efficacy, masticatory function and comfort in patients with dentition defects. METHODS: The clinical data of 90 patients with single tooth loss treated in Yuyao People's Hospital of Zhejiang Province from May 2018 to May 2020 were analyzed retrospectively. The patients were enrolled and divided into two groups. The control group (CG; n=45) was intervened by traditional fixed partial denture (FPD) restoration, and the observation group (OG; n=45) was treated with dental implant restoration. The clinical efficacy was evaluated, and amelioration of tooth-related indexes and clinical indicators 2 years after treatment were observed. The improvement of masticatory function and comfort scores were compared. The adverse reactions during treatment were recorded, and patients' satisfaction with the treatment was calculated. Logistic regression was performed to assess the independent risk factors for inefficacy of the treatments. RESULTS: After treatment, the OG presented with lower gingival index, plaque index and sulcus bleeding index.

Orthodontic treatment combined with 3D printing guide plate implant restoration for edentulism and its influence on mastication and phonic function.

BACKGROUND: Dentition defect, a common clinical oral disease developed in humans, not only causes masticatory dysfunction and articulation difficulties but also affects facial appearance and increases the burden on the intestinal tract. Restorative treatment is the primary option for this disease. However, traditional restorations have many drawbacks, such as mismatch with the body, low reliability, and incomplete occlusal function recovery. AIM: to analyze the efficacy of orthodontics combined with 3D printing guide plate implant restoration in treating patients with dentition defects and its influence on masticatory and phonic functions. METHODS: A prospective study was carried out in 86 patients with dentition defects who received implant prosthesis after orthodontic treatment in our hospital between January 2018 and January 2019. Those patients were divided into a control group and an intervention group with 43 patients in each group using a random number table. The control group received traditional implant restoration, whereas the intervention group received 3D printing guide plate implant restoration. Treatment outcomes, cosmetic appearance, dental function, implant deviation, and quality of life were compared between the two groups. RESULTS: The overall response rate in the intervention group was significantly higher than that in the control group (95.35% vs 81.40%, χ 2 = 4.071, P = 0.044). The number of cases with neatly trimmed cosmetic appearance (χ 2 = 4.497, P = 0.034), complete coverage (χ 2 = 4.170, P = 0.041), and normal occlusion (χ 2 = 5.512, P = 0.019) in the intervention group was higher than that in the control group. After treatment, mastication, swallowing, and articulation were significantly improved in both groups. Masticatory (t = 2.980, P = 0.004), swallowing (t = 2.199, P = 0.031), and phonic functions (t = 3.950, P = 0.004) were better in the intervention group than those in the control group. The deviation value and the deviation angle (t = 5.440, P = 0.000) at the top (t = 6.320, P = 0.000) and middle parts of the implants (t = 22.295, P = 0.000) in the intervention group were lower than those in the control group after treatment. Functional limitations, psychosocial and physical pain and discomfort, and total scores decreased in both groups. The functional limitation (t = 2.379, P = 0.020), psychosocial (t = 2.420, P = 0.000), physical pain and discomfort (t = 6.581, P = 0.000), and total scores (t = 2.140, P = 0.035) were lower in the intervention group than those in the control group. CONCLUSION: Orthodontic treatment combined with 3D printing guide plate implant restoration can significantly improve the masticatory and phonic functions, quality of life, and psychological health of patients with dentition defects. Therefore, it is highly recommended in clinic application.

The effect of denture restoration and dental implant restoration in the treatment of dentition defect: a systematic review and meta-analysis.

BACKGROUND: Dentition defect is a common symptom in clinical dental patients. This study compared the clinical effects of denture restoration and dental implant restoration in the treatment of dentition defects through meta-analysis. METHODS: Data retrieval was conducted through the PubMed, Web of Science, Embase, CNKI, and Wanfang databases. A total of 479 related literatures published in English or Chinese from 2013 to 2020 were included. Literature screening, data extraction and comprehensive evaluation, and analysis by meta-analysis was performed by 3 authors. RESULTS: A total of 17 studies and 1,459 patients were included. Among the 17 studies, the effective rate of treatment between the two groups was compared and the experimental group rate was significantly higher than that of the control group [odds ratio (OR) =6.149, 95% confidence interval (CI): 4.103-9.215, P<0.001]; the mastication function score was compared, and was higher in the experimental group than in the control group [standardized mean difference (SMD) =1.632, 95% CI: 1.039-2.224, P<0.001]; the retention function score was compared, and was higher in the experimental group than in the control group (SMD =1.775, 95% CI: 1.095-2.455), P<0.001); the aesthetics score was also compared, and was higher in the experimental group than in the control group (SMD =1.300, 95% CI: 0.499-2.100, P=0.001). Among 17 studies, 15 compared the comfort score, which was higher in the experimental group than in the control group (SMD =1.357, 95% CI: 0.455-2.258, P=0.003). CONCLUSIONS: Compared with denture restoration, dental implant restoration is more effective in the treatment of dentition defect with a higher comprehensive score of functional restoration.

[Clinical application on restoration of dentition defects using tooth-alveolar bone grafts].

OBJECTIVE: To evaluate the clinical effectiveness of tooth-alveolar bone grafts in repairing dentition defects. METHODS: Forty-five patients with dentition defect were divided into two groups according to different operation methods. In group A (n=24), the tooth-alveolar bone grafts of the transplanted tooth and its surrounding alveolar bone were cut using modified surgical orthodontics and then embedded into the designated planting hole. In group B (n=21), the teeth were extracted through conventional tooth transplantation and then embedded into the prepared planting holes. The transplanted teeth were fixed for about 4-6 weeks using the orthodontic method. During the postoperation, which lasted for 2-12 weeks, root canal treatments were administered selectively. The medical effect was regularly followed up and evaluated. RESULTS: No significant difference was found in the change of color and the periodontal ligament image between the two groups (P>0.05) whereas significant differences were observed in the degree of tooth mobility, the absorption of root and alveolar bone, and the rate of root canal treatment (P<0.05). The curative effect in group A was superior to group B. CONCLUSIONS: Tooth-alveolar bone graft transplantation has overcome some of the limitations of traditional tooth transplantation. Therefore, it is an effective means of repairing dentition defect.