ABSTRACT
BACKGROUND: The objective of this work was to investigate the association between the function of the stomatognathic system and migraine presence through an instrumental functional analysis in a group of diagnosed migraine patients and a control group. METHODS: This study included 50 individuals in each group. A jaw-tracking analysis was performed using Cadiax 4. Tracings of the following movements were recorded: open/close, protrusion/retrusion, mediotrusion, speech, bruxing, and mastication. The tracings were evaluated for their quantity, quality, transversal characteristics, speed, curvature pattern, and condylar stability. RESULTS: Statistically significant differences between the groups were established for several aspects of the evaluation. Migraineurs presented with (a) higher values of mandibular lateral translation in protrusion/retrusion (p = 0.001), open/close (p = 0.031), and mastication (p = 0.016); (b) transient velocity losses in open/close (p = 0.001) and protrusive movements (p = 0.018); (c) a compromised condylar stability for protrusion/retrusion (p = 0.001) and mediotrusion (p = 0.003); (d) a compromised quality for protrusion/retrusion (p < 0.001) and mediotrusion (p = 0.003); and (e) a more frequent "figure-eight" curvature in open/close (p = 0.012). CONCLUSIONS: The importance of the stomatognathic function in migraine pathogenesis and treatment should be considered by using a patient-centered and interdisciplinary approach.
ABSTRACT
PURPOSE: To integrate extra-oral facial scanning information with CAD/CAM complete dentures to immediately rehabilitate terminal dentition. MATERIALS AND METHODS: Ten patients with terminal dentition scheduled for total extraction and immediate denture placement were recruited for this study. The patients were submitted to a facial scanning procedure using the in-office PritiMirror scanner with bite registration records in-situ. Definitive stone cast models and bite records were subsequently submitted to a lab scanning procedure using the lab scanner (iSeries DWOS; Dental Wings). The scanned models were used to create a virtual teeth setup of a complete denture. Using the intra-oral bite records as a reference, the virtual setup was incorporated in the facial scan thereby facilitating a virtual clinical evaluation (teeth try-in) phase. After applying necessary adjustments, the virtual setup was submitted to a CAM procedure where a 5-axis industrial milling machine (M7 CNC; Darton AG General) was used to fabricate a full-milled PMMA immediate provisional prosthesis. RESULTS: Total extractions were performed, the dentures were immediately inserted, and subjective clinical fit was evaluated. The immediate provisional prostheses were inserted and clinical fit, occlusion/articulation, and esthetics were subjectively assessed; the results were deemed satisfactory. All provisional prostheses remained three months in function with no notable technical complications. CONCLUSION: Ten patients with terminal dentition were treated using a complete digital approach to fabricate complete dentures using CAD/CAM technology. The proposed technique has the potential to accelerate the rehabilitation procedure starting from immediate denture to final implant-supported prosthesis leading to more predictable functional and aesthetics outcomes.
ABSTRACT
STATEMENT OF PROBLEM: Complete-mouth implant-supported rehabilitations are challenging because of the multiple surgical and prosthetic steps involved in clinical evaluations to assure passive prosthesis fit and optimal esthetic and functional outcomes. As a result, these rehabilitations are usually associated with substantial clinical time, patient discomfort, and high treatment cost. PURPOSE: The purpose of this pilot clinical study was to evaluate a novel digital approach integrating digital intraoral dental and extraoral facial scanning information to design and mill a computer-aided design and computer-aided manufacturing (CAD-CAM) implant-retained prosthesis for patients with complete edentulism. MATERIAL AND METHODS: Ten patients in need of complete-mouth rehabilitation were included in this pilot study. Digital intraoral records were obtained through optical scanning the duplicate interim prosthesis using a laboratory scanner, while digital extraoral records were obtained through facial scanning using an in-office scanner. The scanned impressions and occlusal records were used to create a virtual tooth arrangement, which was matched to the patient's 3-dimensional face scan to create a virtual clinical evaluation phase. After applying the necessary adjustments, the virtual arrangement was submitted to a CAM procedure where a 5-axis industrial milling machine was used to fabricate an interim prosthesis. RESULTS: Digital intraoral and extraoral records were integrated and used to fabricate CAD-CAM milled interim prostheses, which were inserted and assessed for clinical fit, occlusion/articulation, and esthetics. The prostheses remained in function for at least 6 months with no notable technical or biological complications except for 1 prosthesis that fractured. CONCLUSIONS: A novel digital workflow incorporating facial scanning in a CAD-CAM workflow was used to fully digitally design and mill 10 implant-retained interim prostheses. More research is required to further develop and assess the accuracy and applicability of this approach.
