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

Abstract

Purpose: To evaluate the impact of a full digital workflow on the restoration of masticatory function and esthetic features in subjects rehabilitated with a 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 scans, facial 3D-photos, jaw kinematics recording, and CBCT extended to the temporomandibular joint (TMJ). The subjects were consecutively treated with a fixed prosthesis following surgical and implant therapy using a full digital individualized workflow. Three different study moments were set: diagnostic phase (T0), 1 week after the delivery of the prototype (T1), and 1 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 = .010), frontal movements increased by 7.2 ± 5.6 mm (95% CI from 3.6 to 10.8, P = .001), and horizontal movements increased by 1.7 ± 4.5 mm (95% CI from -1.1 to 4.6, P = .210). Occlusal adjustment timing at T1 was 350 ± 175 seconds, while at T2 it was 677 ± 286 seconds. At T2, functional visual analog scale (VAS) was 9.4 ± 0.4 while esthetic 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 esthetic satisfaction by all the subjects.