背景:本病例报告强调了标准化和全数字化序贯治疗在复杂咬合康复病例中的重要性。为了充分解决患者的牙科需求,这种情况通常需要多学科干预,包括牙周治疗,牙髓治疗,前美学,植入物修复,假肢康复。完全数字化的工作流程(包括面部扫描仪,口内扫描仪,下颌运动跟踪系统,虚拟咬合器,和计算机辅助设计软件)简化了复杂的处理,增强工作流程的简单性,效率,可见性,和精度。
方法:患者表现为上下假体咀嚼效率下降,前牙的美学外观令人不满意。体格检查和放射学评估后,这个复杂的咬合康复案例需要牙周治疗,前美学增强,植入物修复,和固定假肢康复。因此,采用了完全数字化的工作流程。全冠假体放置在牙齿13、23和34上;固定桥包含位置32至42,单个植入物冠放置在牙齿35和36上。为牙齿12至22和44至46构造植入物支撑的固定桥,并通过植入物固定在牙齿12、22、44和46处。所有确定的假体都是由氧化锆陶瓷制成的,因其耐用性和美学特性而选择。最后,具有令人满意的美学和功能特征的修复体就座,保护牙齿及其支撑结构。在治疗和随访期间,T扫描咬合分析系统用于连续监测和指导患者牙弓咬合分布的调整。18个月后,患者仍然对最终的修复感到满意。
结论:本报告旨在帮助牙医了解和实施复杂咬合康复病例管理过程中的标准化和完全数字化工作流程;它还可以促进美学和功能特征的和谐融合。
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.
METHODS: 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.