Seon-Ki Lee; Hong-So Yang; Sang-Won Park; Hyun-Pil Lim; Kwi-Dug Yun

doi:10.4047/jkap.2016.54.3.291

Journal List > J Korean Acad Prosthodont > v.54(3) > 1034886

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Lee, Yang, Park, Lim, and Yun: Rehabilitation using twin-stage method for a Sjögren's syndrome patient with severe discoloration and attrition on upper and lower anterior teeth

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J Korean Acad Prosthodont 2016;54(3):291-297.

Published online: 18 December 2016

DOI: https://doi.org/10.4047/jkap.2016.54.3.291

Rehabilitation using twin-stage method for a Sjögren's syndrome patient with severe discoloration and attrition on upper and lower anterior teeth

Seon-Ki Lee, Hong-So Yang, Sang-Won Park, Hyun-Pil Lim, Kwi-Dug Yun^∗

Department of Prosthodontics, School of Dentistry, Chonnam National University, Gwangju, Republic of Korea

∗Corresponding Author: Kwi-Dug Yun Department of Prosthodontics, School of Dentistry, Chonnam National University, 33 Yongbong-ro, Buk-gu, Gwangju 61186, Republic of Korea +82 (0)62 530 5631: e-mail, ykd@jnu.ac.kr

Received 17 December 201518 March 2016 Accepted 22 March 2016

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Patients with Sjögren's syndrome usually suffer from teeth discoloration and attrition due to xerostomia. If the anterior teeth are badly worn, problems such as loss of anterior guidance, occlusal disharmony, and limited space for restoration may occur. However, ideal occlusion is obtained in both centric and eccentric relation by regaining the dis-occlusion of the posterior teeth through the anterior and lateral guidance using twin-stage method. In this case, rehabilitation was performed for a Sjögren's syndrome patient with maxillary and mandibular incisor's severe attrition and teeth discoloration by using twin-stage method. (J Korean Acad Prosthodont 2016;54:291-7)

Keywords: Sjö, gren's syndrome, Twin-stage method, Double scanning technique, Computer aided design-computer aided manufacturing (CAD-CAM)

REFERENCES

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Fig. 1.

Initial panoramic radiograph.

Fig. 2.

Initial intraoral photographs. Anterior teeth with discoloration and attrition. (A) Frontal view, (B) Maxillary occlusal view, (C) Mandibular occlusal view.

Fig. 3.

Twin-stage method on working cast. (A) Working model with separate die mounted on the Twin-Hoby articulator, (B) Maxillary working model, (C) Mandibular working model.

Fig. 4.

Articulator adjustment values for mutually protected articulation of condition 1. (A) Working model with die separated, (B) Lateral wing angle 10^°, (C) Sagittal inclination 25^° .

Fig. 5.

Articulator adjustment values for mutually protected articulation of condition 2. (A) Diagnostic wax pattern, (B) Lateral wing angle 20^°, (C) Sagittal inclination 45^° .

Fig. 6.

Teeth preparation for CAD-CAM provisional restoration. (A) Abutment preparation, (B) Fabrication of 1st provisional restoration with vacuum sheet, (C, D) Impression for double scanning technique.

Fig. 7.

Double scanning technique for provisional restoration. (A) Abutment scanning, (B) Superimposition, (C) 2nd provisional restoration, (D) 2nd provisional restoration delivery.

Fig. 8.

Double scanning technique for definitive prosthesis. (A, B, C) Final impression, (D, E) superimposition, (F) Full contour monolithic zirconia crown.

Fig. 9.

Definitive restoration. (A) Right lateral view at canine guidance, (B) Frontal view, (C) Left lateral view at canine guidance.

Fig. 10.

Patient's profile. (A) Non-esthetic profile at first visit, (B) Esthetic profile after definitive prosthesis placement.

Table 1.

Articulator adjustment values for mutuallry protected articulation (degrees)

Condition	Condylar path		Anterior guidance
Condition	Sagittal condylar path inclination	Bennett angle	Sagittal inclination	Lateral wing angle
1	25	15	25	10
2	40	15	45	20

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