Immediate Denture Fabrication Utilizing an Innovative Digital Workflow

 |  Noura Al-Kubaisi, BDS  |  Hyunok C. Jo, DMD, MS  |  Jared G. Urban, BS  |  Wenchou Wu, DDS, MS, FACP, AFAAMP  |

 

Introduction:

Computer-aided design (CAD) and Computer-aided manufacturing (CAM) technology has become an integral component of contemporary dental practice. These advancements have been used for different types of dental prosthesis, including inlays, onlays, fixed, and removable dental prostheses. The conventional method of removable denture fabrication has been clinically applied for nearly a century. However, this method necessitates multiple appointments, intricate laboratory procedures and increased cost for both the patient and clinician. CAD/CAM fabricated digital dentures offer many advantages which include reduced clinical visits, reduced cost for patient and clinician, enhanced predictability and easily reproducible. This report describes a new digital workflow for the fabrication of a mandibular immediate denture opposing a maxillary fixed dental prosthesis.

 

Objective:

The objective of this clinical study is to assess the clinical feasibility of fabricating an immediate denture through the utilization of an innovative digital workflow.

 

Patient Presentation:

80-year-old male patient presented at the prosthodontics clinic of Columbia University, with a chief complaint of impaired masticatory function due to fractured mandibular dentition. Clinical evaluation and radiographic assessment revealed multiple retained roots on the mandible opposing a maxillary fixed dental prosthesis. Patient presented with a collapsed bite. All retained dental roots on the mandible were planned for extraction and delivery of immediate denture. A  digital workflow was implemented for the fabrication of the mandibular immediate denture and delivery in three clinical visits.

 

Conclusion:

In this report, the 3-clinical appointments digital technique used for fabrication of a mandibular immediate denture opposing maxillary fixed dental prosthesis was described. This technique combined border molding and final impressions with recording of maxillomandibular relations in a single visit. The digital workflow provided a clinically successful outcome with few adjustments, fewer clinical appointments while achieving optimal fit and retention with denture. The digital technique used has several advantages 1) only three clinical appointments was required (optional wax try-in); 2) can be duplicated for fabrication of radiographic or surgical guide for future surgical implant placement 3) modifications can be readily implemented, such as altering teeth mould or shade 4) simplified refabrication in instances of denture loss or fracture due to the history of digital record.