Digital full-mouth fixed occlusal reconstruction (partⅠ): the “5-19N” clinical technical solution for dentulous situation

doi:10.7518/hxkq.2025.2025003

Abstract

Abstract:

Occlusal rehabilitation is an effective means of treating tooth wear, edentulous jaws and other oral diseases. Among them, full-mouth fixed occlusal reconstruction can effectively restore aesthetics and function, but the complexity of the clinical process, the high sensitivity of the technique, and the high incidence of various complications have always drawn much attention. With the application and development of digital technology in occlusal rehabilitation, the treatment outcome has been improved compared with traditional treatment. However, there are many kinds of digital technology with different efficacy, how to build an efficiently standardized digital clinical technical solution is a current difficulty. Therefore, combined with the long-term work of the department of prosthodontics in our hospital, in this paper, the minimum (occlusal perception of thickness) and maximum (centric relation) geometric quantities which should be paid attention to during reconstruction are put forward. We systematically organized the clinical procedure of digital full-mouth fixed occlusal rehabilitation used in our department for a long time. In conclusion, a 5-stage 19-step or n-step solution (5-19N for short) characterized by “from large to small” restorative space splitting logic is proposed. It has a certain reference value for the future use of digital technology to deal with complex occlusal rehabilitation cases.

Key words: digital, occlusal rehabilitation, fixed restoration, clinical solution, accuracy

CLC Number:

R783.4

Yu Haiyang, Wu Jiacheng, Shui Yusen, Yan Zhebin, Pei Yapeng. Digital full-mouth fixed occlusal reconstruction (partⅠ): the “5-19N” clinical technical solution for dentulous situation[J]. West China Journal of Stomatology, 2025, 43(3): 325-335.

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References 35

1	王惠芸, 邢惠周, 卜维亚. 颞颌关节功能紊乱症的病因及治疗[J]. 解放军医学杂志, 1964, 1(4): 291-293.
	Wang HY, Xing HZ, Bu WY. The etiology and treatment of temporomandibular joint dysfunction[J]. Med J Chin PLA, 1964, 1(4): 291-293.
2	Muts EJ, van Pelt H, Edelhoff D, et al. Tooth wear: a systematic review of treatment options[J]. J Prosthet Dent, 2014, 112(4): 752-759.
3	金晓婷, 赵维家, 罗洁, 等. 咬合重建: 科学与艺术的结合[J]. 口腔颌面修复学杂志, 2023, 24(1): 1-6.
	Jin XT, Zhao WJ, Luo J, et al. Full-mouth occlusal reconstruction: science and art[J]. Chin J Prosthodont, 2023, 24(1): 1-6.
4	姜婷, 张海. 全口咬合重建[M]. 北京: 人民卫生出版社, 2015.
	Jiang T, Zhang H. Full mouth rehabilitation[M]. Beijing: People’s Medical Publishing House, 2015.
5	杨乐, 朱锦跃, 孟志兵, 等. 牙齿重度磨耗患者固定及可摘局部义齿咬合重建的临床效果[J]. 现代仪器与医疗, 2017, 23(6): 46-47, 50.
	Yang L, Zhu JY, Meng ZB, et al. Clinical effect of fixed and removable partial denture occlusal reconstruction in patients with severe tooth wear[J]. Modern Instru Med Treat, 2017, 23(6): 46-47, 50.
6	Lepidi L, Suriano C, Wang HL, et al. Digital fixed complete-arch rehabilitation: from virtual articulator moun-ting to clinical delivery[J]. J Prosthet Dent, 2022, 127(3): 398-403.
7	Lanis A, Gallucci G, Pedrinaci I. Full mouth oral rehabi-litation of a severely worn dentition based on a fully di-gital workflow[J]. J Esthet Restor Dent, 2023, 35(4): 596-608.
8	Liu XQ, Zhou T, Gao HQ, et al. Three-point sectional-cast digital method for transferring the interocclusal relationship for full-mouth rehabilitation of worn dentition[J]. J Prosthodont, 2023, 32(3): 273-277.
9	Lundqvist S, Haraldson T. Occlusal perception of thickness in patients with bridges on osseointegrated oral implants[J]. Scand J Dent Res, 1984, 92(1): 88-92.
10	Kampe T, Haraldson T, Hannerz H, et al. Occlusal perception and bite force in young subjects with and wi-thout dental fillings[J]. Acta Odontol Scand, 1987, 45(2): 101-107.
11	Kiliaridis S, Tzakis MG, Carlsson GE. Short-term and long-term effects of chewing training on occlusal perception of thickness[J]. Scand J Dent Res, 1990, 98(2): 159-166.
12	何三纲, 于海洋. 口腔解剖生理学[M]. 8版. 北京: 人民卫生出版社, 2020.
	He SG. Oral anatomy and physiology[M]. 8th ed. Beijing: People’s Medical Publishing House, 2020.
13	The glossary of prosthodontic terms 2023 tenth edition[J]. J Prosthet Dent, 2023, 130(4): e7-e126.
14	徐军. 口腔修复学常用词汇——歧义名词与定义分析[M]. 北京: 人民卫生出版社, 2022.
	Xu J. Common vocabulary in prosthodontics—Ambiguous nouns and definition analysis[M]. Beijing: People’s Medical Publishing House, 2022.
15	Kattadiyil MT, Alzaid AA, Campbell SD. What materials and reproducible techniques may be used in recording centric relation? Best evidence consensus statement[J]. J Prosthodont, 2021, 30(S1): 34-42.
16	Zhao MY, Wang PQ, Wang HZ, et al. Diagnostic and treatment protocol for a patient with temporomandibu-lar disorder using a stabilization splint and temporary anchorage devices[J]. Am J Orthod Dentofac Orthop, 2021, 159(5): 666-681.e2.
17	Song F, He SS, Chen S. Temporomandibular disorders with skeletal open bite treated with stabilization splint and zygomatic miniplate anchorage: a case report[J]. Angle Orthod, 2015, 85(2): 335-347.
18	Greene C, Manfredini D. Overtreatment “successes”: what are the negative consequences for patients, dentists, and the profession?[J]. J Oral Facial Pain Heada-che, 2023, 37(2): 81-90.
19	Greene C, Manfredini D, Ohrbach R. Creating patients: how technology and measurement approaches are misused in diagnosis and convert healthy individuals into TMD patients[J]. Front Dent Med, 2023, 4: 1183327.
20	Schiffman E, Ohrbach R. Executive summary of the diagnostic criteria for temporomandibular disorders for clinical and research applications[J]. J Am Dent Assoc, 2016, 147(6): 438-445.
21	Greene C, Manfredini D. Treating temporomandibular disorders in the 21st century: can we finally eliminate the “third pathway”?[J]. J Oral Facial Pain Headache, 2020, 34(3): 206-216.
22	赵铱民. 口腔修复学[M]. 8版. 北京: 人民卫生出版社, 2020.
	Zhao YM. Prosthodontics[M]. 8th ed. Beijing: People’s Medical Publishing House, 2020.
23	李全利, 曹颖, 武郭敏, 等. 一种牙齿重度磨耗的全牙列固定修复咬合重建方案[J]. 口腔医学, 2022, 42(12): 1080-1085.
	Li QL, Cao Y, Wu GM, et al. A fixed occlusal rehabilitation protocol for severely worn dentition[J]. Stomatology, 2022, 42(12): 1080-1085.
24	刘小雅, 罗寒, 刘天爽. 重度磨耗微创咬合重建的临床效果分析[J]. 口腔颌面修复学杂志, 2022, 23(4): 272-276.
	Liu XY, Luo H, Liu TS. Clinical evaluation of minimal invasive occlusal reconstruction of patients with severely worn teeth[J]. Chin J Prosthodont, 2022, 23(4): 272-276.
25	于海洋, 颜哲彬, 解晨阳, 等. 正中关系的临床决策[J]. 华西口腔医学杂志, 2024, 42(5): 558-565.
	Yu HY, Yan ZB, Xie CY, et al. Clinical decision of centric relation[J]. West China J Stomatol, 2024, 42(5): 558-565.
26	Hassall D. Centric relation and increasing the occlusal vertical dimension: concepts and clinical techniques—part one[J]. Br Dent J, 2021, 230(1): 17-22.
27	Rodrigues Garcia RC, Oliveira VM, Del Bel Cury AA. Effect of new dentures on interocclusal distance during speech[J]. Int J Prosthodont, 2003, 16(5): 533-537.
28	Geerts GA, Stuhlinger ME, Nel DG. A comparison of the accuracy of two methods used by pre-doctoral students to measure vertical dimension[J]. J Prosthet Dent, 2004, 91(1): 59-66.
29	Naeem S, Oamar K, Khan M. Determination of lower facial height through mandibular morphology using lateral cephalometery[J]. Pakistan Oral Dent J, 2013, 33(2): 384.
30	于海洋, 李俊颖. 目标修复体空间的内涵、分析设计及临床转移实施[J]. 华西口腔医学杂志, 2015, 33(2): 111-114.
	Yu HY, Li JY. The concept, clinical design and transfer application of target restoration space[J]. West China J Stomatol, 2015, 33(2): 111-114.
31	于海洋, 罗天. 目标修复体空间中的数量及数量关系在精准美学修复中的应用[J]. 华西口腔医学杂志, 2016, 34(3): 223-228.
	Yu HY, Luo T. Application of target restoration space quantity and quantitative relation in precise esthetic pro-sthodontics[J]. West China J Stomatol, 2016, 34(3): 223-228.
32	Lepidi L, Galli M, Mastrangelo F, et al. Virtual articu-lators and virtual mounting procedures: where do we stand?[J]. J Prosthodont, 2021, 30(1): 24-35.
33	Li JY, Sommer C, Wang HL, et al. Creating a virtual patient for completely edentulous computer-aided implant surgery: a dental technique[J]. J Prosthet Dent, 2021, 125(4): 564-568.
34	孙欣荣, 冯玥, 刘伟才. 多模态数据融合的可视化技术在咬合重建中的应用[J]. 华西口腔医学杂志, 2022, 40(4): 468-475.
	Sun XR, Feng Y, Liu WC. Application of visualization technology of multimode data fusion in occlusal rehabilitation[J]. West China J Stomatol, 2022, 40(4): 468-475.
35	Gao J, Li JY, Liu CX, et al. A stereolithographic template for computer-assisted teeth preparation in dental esthetic ceramic veneer treatment[J]. J Esthet Restor Dent, 2020, 32(8): 763-769.

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