Modifications of functionally generated path procedures

A Technique to Fabricate a New Crown to an Existing Removable Partial Denture

Fabricating a crown for a tooth that serves as an abutment for an existing removable partial denture (RPD) provides a restorative challenge. Typically, the compromised tooth requiring an extra-coronal restoration is initially restored. It is followed by the construction of a new RPD that accurately fits the restored abutment. An increasingly common scenario is that the existing RPD is deemed clinically acceptable and, therefore, does not require replacing. This results in the clinical dilemma of fabricating a crown for an abutment tooth, while also considering how the contours of this restoration will fit with the RPD's clasps and rests. This can be achieved through the use of various techniques subdivided into indirect, direct and combined indirect-direct. This article describes an indirect-direct technique used in conjunction with the functionally generated path technique to achieve accurately a stable record of the patient's occlusion in the fabrication of a new crown to an existing RPD.

Design of occlusal wear facets of fixed dental prostheses driven by personalized mandibular movement

STATEMENT OF PROBLEM

Existing virtual articulators simulate mandibular movement by using various parameters and are used to design restorations. However, they are not able to reproduce actual patient movements, and the designs of occlusal wear facets by them and by personalized mandibular movement have not been compared.

PURPOSE

The purpose of this clinical study was to establish a clinical application protocol for a virtual articulator based on previous research and to evaluate the accuracy of the occlusal wear facets designed by it.

MATERIAL AND METHODS

The gypsum casts of 12 participants were scanned with a cast scanner as the original data. A single crown, 3-unit splinted crowns, a 5-unit fixed partial denture, and a fixed complete denture were virtually prepared on the digital mandibular casts by using the Geomagic Studio 2013 software program. High points were created at the wear facets, and corresponding digital wax patterns with occlusal interferences were generated. The exocad software program was used to design corresponding restorations with the copy method. Static (STA restoration) and dynamic (DYN restoration) occlusal adjustments were carried out with the built-in virtual articulator. The mandibular movements of participants were recorded by the novel virtual articulator system, and the occlusal surfaces of the digital wax patterns were adjusted (FUN restoration). The restorations adjusted with the 3 methods were compared with the original data. The mean value and root mean square (RMS) of 3D deviation and positive volumes (V+) in the occlusal direction were measured. Depending on the normality, 1-way ANOVA and the Kruskal-Wallis test were used to analyze the influence of occlusal surface design methods on the morphology of occlusal wear facets (α=.05).

RESULTS

The mean deviation of the 4 kinds of STA restorations ranged from 0.19 mm to 0.22 mm, the DYN restorations from 0.13 mm to 0.17 mm, and the FUN restorations from 0.03 mm to 0.09 mm. A significant difference was found between the STA and FUN restorations of the 3-unit splinted crowns and 5-unit fixed partial dentures (Ρ=.013, Ρ=.021). The mean values of 3D deviation and V+ decreased from the STA group to the DYN group and then to the FUN group. The RMS and V+ were statistically similar (Ρ>.05).

CONCLUSIONS

The preliminary results of the study indicate that the FUN 3-unit splinted crowns and 5-unit fixed partial dentures designed with the self-developed virtual articulator were better than the STA restorations. The FUN restorations were more coincident with the morphology of the wear facets on the original teeth.

A Comparative Evaluation of the Effect of Double Casting Technique Using Functionally Generated Path and Conventional Single Casting with Respect to Functional Articulation, Patient Satisfaction and Chair Side Time, in Single Unit Molar Teeth: An In Vivo Study

A stable centric occlusal position that shows no evidence of occlusal disease should not be altered. Confirmative restorative dentistry deals with making restorations that are in harmony with existing jaw relations. Conventional techniques for construction have been unsuccessful in producing a prosthesis that can be inserted without minor intraoral occlusal adjustment. This study was conducted to evaluate the benefits of the double casting technique with FGP over the conventional casting technique. Ten patients with root canal treated maxillary molar were selected for the fabrication of metal crown. Two techniques, one involving the conventional fabrication and other using functionally generated path with double casting were used to fabricate the prosthesis. A comparison based on various parameters which was done between the two techniques. The change in the height of castings for the double casting group was less compared to the conventional group and was highly statistically significant (P < 0.001). The time taken for occlusal correction was significantly lower in double casting group than the conventional group (P < 0.001). The patient satisfaction (before occlusal correction) indicated better satisfaction for double casting group compared to conventional (P < 0.01). The functionally generated path with double casting technique resulted in castings which had better dimensional accuracy, less occlusal correction and better patient satisfaction compared to the conventional castings.