In modern dentistry, Computer-Aided Design and Manufacturing (CAD/CAM) is a promising technology that allows fabrication of prosthetic restorations through milling procedures. Over years, with the continuous improvement of technology, direct CAD/CAM or “chairside” technology is becoming a widespread approach which offers immediate rehabilitation with long-term rates reported by several studies compared to conventional techniques. All steps are generally carried out in the dental office during the same treatment session. The present paper is about a healthy female patient with a decayed 36 tooth which was restored by ceramic onlay using Planmeca’s PlanCAD system. Through the present clinical case, a detailed protocol of chairside technology would be presented from the digital impression to the milling process. It would detail impression steps. It would also highlight especially the virtual design confection of prosthetic restoration using a biogeneric model included in the software. It also illustrated tools which could be used by the dentist to perform the design. Also, some useful tips would be presented in order to perform the confection. On this subject, various studies showed the viability of such technology. To summarize, referring to previous studies, this promising technology allows especially time-saving and patient’s comfort compared to the indirect one.
Oral rehabilitation of patients presenting multiple microdontia is a real therapeutic challenge. These alterations in size, often associated with other dental anomalies, have aesthetic and functional repercussions for patients and can lead to significant psycho-social consequences. We report here the case of an 11-year-old patient with bilateral sectorial microdontia and agenesis of teeth numbers 13 and 23. She also presented staturo-ponderal delay and a history of acute coronary syndrome with a lower coronary occlusion of unknown aetiology. At first, additive coronoplasties and an orthodontically retained interim prosthesis answered the aesthetic and functional need during childhood and adolescence. Once she reached adulthood, a multidisciplinary meeting was conducted and a treatment plan was established. The decision was made to rehabilitate the upper arch with a permanent bridge and the lower arch with indirect adhesive restorations. This solution solved the problem of the bilateral lateral infraocclusions and tooth agenesis, restoring both aesthetics and function. This paper presents 15 years of management and treatment of a patient presenting multiple microdontia associated with hypodontia. Both the multidisciplinary approach and coordination between the different medical team members was essential to maintain the existing dentition while preparing, planning, and carrying out a personalized treatment plan once maxillofacial growth was complete.
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