CAD/CAM: Applications for transitional bonding to restore occlusal vertical dimension

Abstract

Objective Explore the best technique for achieving stable and comfortable occlusion. This is critical for long‐term oral health and the foundation of durable esthetic, restorative, periodontal, and prosthodontic treatments. Clinical considerations Various techniques and therapies have been proposed for establishing, determining, and restoring ideal centric relation (CR) and vertical dimension of occlusion (VDO) in patients who require restorations and/or full‐mouth rehabilitation. An interim prosthesis phase can help establish and stabilize an enhanced esthetics and/or functional outcome for a limited period of time before the definitive dental restorations are placed. Transitional direct composite bonding and its additive nature have provided clinicians and patients with advantages when establishing a physiologic CR and VDO in interim restorations. However, it is time consuming, tedious, and challenging chairside. The author has been using additive CAD/CAM designed and milled restorations for over 10 years to make transitional bonding more efficient, manageable, and predictable. Conclusion Transitional bonded prostheses are significantly important to providing patients with an interim therapy to determine if the proposed esthetic outcome and occlusal scheme will function as expected, or if adjustments are needed prior to the delivery of the definitive long‐term restorations. CR and VDO are essential for establishing a functional and healthy occlusion, ideal restoration proportions and smile design, and treatment planning esthetic and prosthodontic restorations for long‐term durability. Clinical significance This article reviews CR, VDO, and the characteristics of a CAD/CAM transitional bonding technique in reversing the signs and symptoms of a compromised dentition and reestablishing an ideal esthetic and functional occlusal outcome. Transitional bonded prostheses are significantly important to providing patients with an interim therapy to determine if the proposed esthetic outcome and occlusal scheme will function as expected, or if adjustments are needed prior to the delivery of the definitive long term restorations.

Managing the transition to a complex full mouth rehabilitation utilizing injectable composite

“…Using injectable composites in the technique described in this article presents another possbibility to treat these cases. Longevity studies using these materials for complex occlusal changes are lacking, 15,16 but anecdotal evidence suggest that they can function well intraorally for 3–5 years, which is in line with other transitional techniques 17,18 …”

“…Longevity studies using these materials for complex occlusal changes are lacking, 15,16 but anecdotal evidence suggest that they can function well intraorally for 3-5 years, which is in line with other transitional techniques. 17,18…”

Occlusal vertical dimension: an analysis of the accuracy of the Willis method

“…(16) The multiple anatomical variations between individuals lead to different facial measurements and a diversity of dimension values for the VDO. (5,17,18,19,20) It is thus important for dentists to obtain precise measurements for an adequate VDO. Though researchers have challenged the theory of a constant vertical dimension at rest, it is still seen as the first step by most dentists.…”

Reclaiming the Smile: Full Mouth Rehabilitation of a Generalized Attrition Patient Using the Hobo Twin-Stage Technique

“…This ensured that any discrepancies or discomfort in the new occlusal relationship could be addressed before the final restorations were cemented. The use of provisional restorations also allowed for the development of proper occlusal contacts and tooth contours, which were transferred to the final restorations [ 12 , 13 ].…”