Fixed Prosthetic Rehabilitation with Full Digital Workflow Based on Jaw Kinematics Recording. A Case Series.

Abstract

Purpose: The study aims at evaluating the impact of a full digital workflow on the restoration of masticatory function and aesthetic features in subjects rehabilitated with fixed prosthesis.

Materials and methods: The study involved 12 adult participants in need of complex rehabilitation due to masticatory dysfunction. They underwent a comprehensive diagnostic examination involving intraoral scan, facial 3D-photos, jaw kinematics recording, and Cone Beam Computed Tomography extended to temporo-mandibular joint. The subjects were consecutively treated with fixed prosthesis following surgical and implant therapy using a full-digital individualized workflow. Three different study moments were set: diagnostic phase (T0), one week after the delivery of the prototype (T1) and one week after the delivery of the final prosthetic solution (T2).

Results: Jaw kinematics recording showed a widening of movements at T2 compared to T0. Sagittal movements increased by 5.7±6.4 mm (95%CI from 1.7 to 9.8, P = 0.010), frontal movements increased by 7.2±5.6 mm (95%CI from 3.6 to 10.8, P = 0.001), and horizontal movements increased by 1.7±4.5 mm (95%CI from -1.1 to 4.6, P = 0.210). Occlusal adjustment timing at T1 was 350±175 seconds, while at T2 was 677±286. At T2 functional VAS was 9.4±0.4 while aesthetic VAS was 9.3±0.4.

Conclusions: The rehabilitation process using the full digital workflow showed a widening of the sagittal and frontal masticatory movements with short occlusal adjustment time and with functional and aesthetic satisfaction by all the subjects.