Removable occlusal overlay splint in the management of tooth wear: a clinical report

Automated monitoring of tooth wear progression using AI on intraoral scans

OBJECTIVES

This study aimed to develop and evaluate a fully automated method for visualizing and measuring tooth wear progression using pairs of intraoral scans (IOSs) in comparison with a manual protocol.

METHODS

Eight patients with severe tooth wear progression were retrospectively included, with IOSs taken at baseline and 1-year, 3-year, and 5-year follow-ups. For alignment, the automated method segmented the arch into separate teeth in the IOSs. Tooth pair registration selected tooth surfaces that were likely unaffected by tooth wear and performed point set registration on the selected surfaces. Maximum tooth profile losses from baseline to each follow-up were determined based on signed distances using the manual 3D Wear Analysis (3DWA) protocol and the automated method. The automated method was evaluated against the 3DWA protocol by comparing tooth segmentations with the Dice-Sørensen coefficient (DSC) and intersection over union (IoU). The tooth profile loss measurements were compared with regression and Bland-Altman plots. Additionally, the relationship between the time interval and the measurement differences between the two methods was shown.

RESULTS

The automated method completed within two minutes. It was very effective for tooth instance segmentation (826 teeth, DSC = 0.947, IoU = 0.907), and a correlation of 0.932 was observed for agreement on tooth profile loss measurements (516 tooth pairs, mean difference = 0.021mm, 95% confidence interval = [-0.085, 0.138]). The variability in measurement differences increased for larger time intervals.

CONCLUSIONS

The proposed automated method for monitoring tooth wear progression was faster and not clinically significantly different in accuracy compared to a manual protocol for full-arch IOSs.

CLINICAL SIGNIFICANCE

General practitioners and patients can benefit from the visualization of tooth wear, allowing quantifiable and standardized decisions concerning therapy requirements of worn teeth. The proposed method for tooth wear monitoring decreased the time required to less than two minutes compared with the manual approach, which took at least two hours.

[Dental condiction of patients with temporomandibular dysfunction]

OBJECTIVE

To evaluate the dental condition and the vertical dimension in patients with TMD, and the age and origin of the DTM.

METHODS

Was performed a descriptive study, observational, cross-sectional, with a sample of thirty patients with TMD, diagnosed by Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). This sample was determined based on estimates the service thus a sample of convenience. The association between gender, age, vertical dimension and dental condition with TMD were verified using the chi-square statistical test with 95% confidence intervals.

RESULTS

It found that 26 patients were female and 4 males. Fifteen subjects presented aged below 36.5 years. How much the origin of the DTM, 19 subjects had articular disorder, and 11 muscle disorder. Has been determined that there was no statistically significant association between the independent variables with the DTM.

CONCLUSION

The etiological factors analyzed in isolation do not seem to influence in a unique way in the development of TMD, but may act together with other factors, because the cause is multifactorial.

Full Mouth Reconstruction of a Bruxer with Severely Worn Dentition: A Clinical Report

Tooth wear is attributed to several factors many of which often remain unidentified. Management of tooth wear is challenging in preventive and restorative dentistry. Correct assessment of occlusal vertical dimension, interocclusal rest space, and centric relation records are critical for successful treatment. In order to evaluate different treatment modalities and select the treatment of choice some information can be obtained from study casts and diagnostic wax-up. In order to achieve a predictable and desirable result, a systematic approach may be helpful. This paper describes the full mouth rehabilitation of a 36-year-old bruxer with severely worn dentition and other dental problems such as unfavorable restorations. A diagnostic work-up was performed and provisional restorations were made; then, they were clinically evaluated and adjusted based on the criteria dictating esthetics, phonetics, and vertical dimension. After endodontic therapy, clinical crown lengthening was performed. Two short implants were inserted in the posterior mandible. Custom-cast dowel cores and metal-ceramic restorations were fabricated and a full occlusal splint was used to protect the restorations. We ensured stable contacts on all teeth with equal intensity in centric relation and anterior guidance in accord with functional jaw movements.

A Single Visit Direct Technique to Provisionally Restore Occlusion for a Full-Mouth Rehabilitation: A Clinical Report

Attrition of the dentition can negatively affect esthetics and function. When reconstructing patients with attrition who require restoration at increased occlusal vertical dimension (OVD), it is necessary to first evaluate the OVD using a removable interim prosthesis to ensure that the patient will tolerate the new position. The transition to fixed interim prostheses has to be carefully planned to achieve the desired OVD. One approach is to prepare all teeth in a single day and place full-arch interim prostheses; however, this can be tiring for the patient and prosthodontist. An alternative approach is to prepare one arch and place interim prostheses, while using composite resin in the opposing arch to maintain the newly established OVD. A diagnostic wax-up at the proposed OVD is completed and duplicated in stone. A vacuform matrix is loaded with composite resin and applied to the unprepared etched teeth of the opposing arch to restore form and occlusion until full contour interim prostheses are placed at a later visit.

Esthetic and functional rehabilitation of mutilated dentition and loss of vertical dimension due to amelogenesis imperfecta

Cases of severe attrition are a common finding. Among the congenital anomalies, amelogenesis imperfecta and dentinogenesis imperfecta are important conditions that may cause accelerated wear of teeth. The following case report describes the complete oral rehabilitation of a patient diagnosed with amelogenesis imperfecta. A detailed treatment plan was chalked out which included proper oral hygiene measures, restoration of carious teeth and endodontic treatment followed by foundation restorations of teeth that were crucial for the final prostheses. Patient was given transitional restorations for about 6 weeks with the aim of regaining the lost vertical dimensions. Final rehabilitation was done by fixed dental prostheses.

Implant-Supported Prosthetic Rehabilitation of a Patient with Localized Severe Attrition: A Clinical Report

Patients usually adapt to their existing occlusal vertical dimension (OVD). It is essential to resolve each of the problems associated with decreased vertical dimension as a result of attrition. This report describes the multidisciplinary dental treatment of a 40-year-old male patient who had severe tooth wear, resulting in reduced vertical dimension. After clinical evaluations, extraoral examination showed a reduction of the lower facial height, drooping, and overclosed commissures. Ten dental implants were placed into the maxillary and mandibular alveolar processes. During the osseointegration period, an interim removable partial denture was made at increased OVD to use in the first stage of rehabilitation. It was used for 3 months as a guide for preparing the definitive restorations. The patient's adaptation to the increased OVD was evaluated. During this period, he was asymptomatic. Following the evaluation period, the provisional fixed restoration was used for 3 months. Then, full-mouth definitive prostheses supported by a combination of implants and teeth were fabricated to upper and lower jaws. Osseointegration of the implants, peri-implant mucosa health, prosthesis function, and esthetics were assessed after 1 week and 1, 3, and 6 months. After 3 years of follow-up, no functional or esthetic difficulties with the implants and restorations were noted.

Full mouth rehabilitation of a patient with reduced vertical dimension using multiple metal ce ramic restorations

Rehabilitation of a patient with severely worn dentition after restoring the vertical dimension is a complex procedure and assessment of the vertical dimension is an important aspect in these cases. This clinical report describes the full mouth rehabilitation of a patient who was clinically monitored to evaluate the adaptation to a removable occlusal splint to restore vertical dimension for a period 1 month and provisional restorations to determine esthetic and functional outcome for a period of 3 months. It is necessary to recognizing that form follows function and that anterior teeth play a vital role in the maintenance of oral health. Confirmation of tolerance to changes in the vertical dimension of occlusion (VDO) is of paramount importance. Articulated study casts and a diagnostic wax-up can provide important information for the evaluation of treatment options. Alteration of the VDO should be conservative and should not be changed without careful consideration.

Establishing the maxillary occlusal plane as a requisite for placement of an immediate implant-supported fixed prosthesis in the mandible: a case report

INTRODUCTION: In patients with Bruxism, the attrition can result in excessive occlusal wear that exceeds the compensatory mechanism and loss of occlusion vertical dimension occurs. OBJECTIVE: The purpose of this article is to show the importance of re-establishing an adequate occlusal plane for the non treated arch by means of a fixed acrylic overlay, compatible with the prosthetic treatment of the arch to be rehabilitated. An upper maxillary fixed acrylic overlay restored the patient’s occlusal plane in an appropriate vertical dimension of occlusion together with a fixed prosthesis in the mandible, supported by five dental implants. CONCLUSION: When there is severe wear due to dental attrition in one of the arches, it is important to re-establish the occlusal plane and compensation curves in conjunction with the prosthetic treatment of the arch to be rehabilitated.

Reestablishment of occlusion through overlay removable partial dentures: a case report

Loss of posterior teeth may cause an imbalance in the stomatognathic system. Overlay removable partial dentures (ORPD) are a reversible and relatively inexpensive treatment for patients with severely worn teeth. This paper presents a treatment with ORPD in a 55-year-old male patient who had severe attrition in the maxillary and mandibular teeth, temporomandibular joint pain and reduced vertical dimension of occlusion (VDO). The treatment consisted in the reestablishment of the VDO using Lucia's jig, fabricating removable partial denture with reconstruction of the worn teeth without preparation. This therapy can be used as an alternative treatment to provide esthetic, function and stable occlusion in patients with severely worn teeth.

An appraisal on increasing the occlusal vertical dimension in full occlusal rehabilitation and its outcome

Increasing the occlusal vertical dimension for gaining sufficient restoration space in the management of severely worn dentition is being practiced. This contentious belief has lead to challenging thoughts regarding its effects on the Odonto-stomatognathic system. There are basic uncertainties and existing erroneous thoughts regarding the perception of increasing the occlusal vertical dimension. This manuscript will review the bite raising concepts and its outcome on the stomatognathic system.

Full mouth rehabilitation of the patient with severely worn dentition: a case report

The severe wear of anterior teeth facilitates the loss of anterior guidance, which protects the posterior teeth from wear during excursive movement. The collapse of posterior teeth also results in the loss of normal occlusal plane and the reduction of the vertical dimension. This case report describes 77-year-old female, who had the loss of anterior guidance, the severe wear of dentition, and the reduction of the vertical dimension. Occlusal overlay splint was used after the decision of increasing vertical dimension by anatomical landmark, facial and physiologic measurement. Once the compatibility of the new vertical dimension had been confirmed, interim fixed restoration and the permanent reconstruction was initiated. This case reports that a satisfactory clinical result was achieved by restoring the vertical dimension with an improvement in esthetics and function.

Oral manifestations in patients with gastro-oesophageal reflux disease: a single-center case-control study

OBJECTIVE

To assess the occurrence of oral pathological changes and symptoms in patients affected by gastro-oesophageal reflux disease (GERD).

PATIENTS AND METHODS

200 patients with GERD and 100 matched healthy controls were studied. Thorough visual examination of the dental and oral mucosal tissues was performed and medical history relevant to oral symptoms was collected. The primary outcome was defined as a statistically significant difference, between the study group and controls, in the presence of the following indicators: soft/hard palate and uvula erythema, tooth wear, xerostomia, oral acid/burning sensation, subjective halitosis and dental sensitivity. Statistical analysis included chi-squared test, and crude odds ratio with 95% CI.

RESULTS

Univariate analysis showed that xerostomia, oral acid/burning sensation, subjective halitosis, and soft and hard palate mucosa and uvula erythema were more common in patients with GERD than matched controls (P < 0.05).

CONCLUSIONS

This study failed to find any significant association between GERD and dental erosions, whereas some symptoms and other objective oral mucosal changes were found to be significantly associated with GERD.

Effects of Bartter's syndrome on dentition and dental treatment: A clinical report

Bartter's syndrome is an autosomal recessive form of severe volume depletion due to renal salt wasting. This clinical report describes the prosthodontic treatment for a 24-year-old man who suffers from Bartter's syndrome. The treatment plan included endodontic treatment of the maxillary anterior incisors and placement of cast dowel-and-core restorations because of reduced crown height. The patient's remaining teeth were restored with metal-ceramic crowns.

Maxillary and mandibular overlay removable partial dentures for the restoration of worn teeth

This clinical report describes the fabrication of maxillary and mandibular cast overlay removable partial dentures for the restoration of severely worn teeth with accompanying loss of vertical dimension of occlusion. The frameworks supported porcelain veneers for esthetics and metal occlusal surfaces for strength and durability.

Tooth wear: use of overlays with metallic structures

This work is a clinical case report of a patient presenting with marked tooth wear in all teeth, a reduction in the vertical dimension of occlusion, and fatigue in the muscles of mastication. The treatment proposed and effected used a muscle-relaxing appliance and mandibular and maxillary overlay appliances which were adjusted according to the occlusal contacts, vertical dimension of occlusion, and the mandibular positioning. The results obtained were satisfactory in terms of relaxing the muscles involved, reestablishing the dimensions of the lower third of the face, and the functional activities of deglutition, mastication, and speech.