Application of a metal occlusal surface and split framework in the treatment of a patient with mandibular distal extension absence and insufficient occlusogingival distance / 口腔疾病防治

Objective@# To investigate the effect of a metal occlusal surface and stress interruption design on minimally invasive prosthodontics for patients with distal extension absence and insufficient occlusal gingival distance.@*Methods @# We retrospectively studied the case of minimally invasive prosthodontic (Vitallium 2000) combined with a metal occlusal surface for distal extension absence in a patient with insufficient occlusal gingival distance; the stress breaking design and pressure impression technology are examined, and relevant articles are reviewd. @*Results@#The design effectively solves the problems of insufficient occlusal gingival distance, large occlusal force and easy denture fracture. Reviewing the relevant literature, stress interruption design can effectively protect abutment teeth, but the behavior of stress interruption design and stress conduction phenomena in the mouths of patients has not been reported. The T-scan test results of this study showed that before and after wearing the denture, the occlusal force distribution ratio of the patient changed from 77.5% on the left and 22.5% on the right to 61.3% on the left and 38.7% on the right. The occlusal force distribution ratio of the right dentition to the total occlusal force increased by 16.2%, and the occlusal force became better distributed. Further analysis showed that the occlusal forces on the left and right sides were nearly the same in the initial occlusion stage. As the occlusal force was further increased, the proportion of the occlusal force on the right side decreased in the middle of the occlusion stage and further decreased in the final occlusion stage until it reached a dynamic balance. The above T-scan test and literature review results suggest that this dynamic balance phenomenon of bite force is related to the stress interruption design and the stress conduction effect of the split framework.@* Conclusion @#The composite of stress interruption design and metal occlusal surface allows for minimally invasive prosthodontics for the treatment of distal extension absence in patients with insufficient occlusal gingival distance.

An alternative treatment of occlusal wear: Cast metal occlusal surface.

Acrylic resin denture teeth often exhibit rapid occlusal wear, which may lead to decrease in the chewing efficiency, loss of vertical dimension of occlusion, denture instability, temporomandibular joint disturbances, etc. There are various treatment options available like, use of highly cross linked acrylic teeth, amalgam or metal inserts on occlusal surface, use of composite, gold or metal occlusal surface, etc. Several articles have described methods to construct gold and metal occlusal surfaces, however, these methods are time-consuming, expensive and requires many cumbersome steps. These methods also requires the patient to be without the prosthesis for the time during which the laboratory procedures are performed. This article presents a quick, simple and relatively inexpensive procedure for construction of metal occlusal surfaces on complete dentures.