2022 ACP Annual Session

INTRODUCTION

•Occlusal Appliances have become regularly used in the practice of prosthodontics.

•The traditional manufacturing methods for these devices have been vacuum thermoforming and sprinkling of acrylic resin.₁

• Nowadays, CAD-CAM technology permits the use of subtracting and additive manufacturing technology with the use of polymethylmethacrylate (PMMA) blanks and printed resin.₁

PURPOSE

• The purpose of this clinical report is to describe a digital workflow for the fabrication of occlusal appliances use in prosthodontic practice.

MATERIALS AND METHOD

CASE REPORT

• A 51 years-old male patient presented in the Advanced Prosthodontic Clinic at the Ohio State University for a comprehensive evaluation. (Fig. 1)

•A diagnostic intraoral scan was taken (TRIOS 3; 3Shape).

•Digital wax-up was made, printed (C&B MFH, NextDent), and tried intraorally.

•After delivering the final restorations, an intraoral scan was made (TRIOS 3; 3Shape). It used Splint Studio of 3Shape Dental System Software for the fabrication of the Occlusal Appliance.

•For the design, the first step was to indicate the occlusal plane and align the occlusal table.

•Following the selection of the articulator of preference, the incisal pin was digitally opened by 2 mm to ensure the thickness of the appliance. (Fig 2 and 3)

•It was selected the path of insertion, blocked undercuts, and designed the outline of the occlusal appliance over the cast. (Fig. 4 and 5)

•It was determined the thickness and offset of the occlusal device from the teeth. (Fig 6)

•Occlusion was adjusted in a dynamic movement of the digital articulator replicating centric relationships and excursive movements. (Fig. 7)

•The occlusal appliance was printed (Ortho Rigid, NextDent) and delivered (Fig. 8 and 9).

DISCUSSION

•Limited studies are available regarding additive manufacturing. More research are required about the wear behavior and storage of 3D-printed occlusal splints. ₂

RESULTS

•Minimal adjustments to the occlusal appliance were made during the delivery.

CONCLUSION

•The digital workflow permits the fabrication of accurate occlusal appliances reducing chairside time. It can be easily duplicated in case of damage.

REFERENCES

Lutz, A. M., Hampe, R., Roos, M., Lümkemann, N., Eichberger, M., & Stawarczyk, B. (2019). Fracture resistance and 2-body wear of 3-dimensional–printed occlusal devices. Journal of Prosthetic Dentistry, 121(1), 166–172. https://doi.org/10.1016/j.prosdent.2018.04.007
Grymak, A., Aarts, J. M., Ma, S., Waddell, J. N., & Choi, J. J. E. (2021). Wear Behavior of Occlusal Splint Materials Manufactured By Various Methods: A Systematic Review. Journal of Prosthodontics, 0, 1–15. https://doi.org/10.1111/jopr.13432
Benli, M., Eker Gümüş, B., Kahraman, Y., Gökçen-Rohlig, B., Evlioğlu, G., Huck, O., & Özcan, M. (2020). Surface roughness and wear behavior of occlusal splint materials made of contemporary and high-performance polymers. Odontology, 108(2), 240–250. https://doi.org/10.1007/s10266-019-00463-1
Perea-Lowery, L., Gibreel, M., Vallittu, P. K., & Lassila, L. (2021). Evaluation of the mechanical properties and degree of conversion of 3D printed splint material. Journal of the Mechanical Behavior of Biomedical Materials, 115(November 2020), 104254. https://doi.org/10.1016/j.jmbbm.2020.104254

2022 ACP Annual Session

Completely Digital Workflow for fabrication of Occlusal Appliances. Case Presentation

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