From Virtual Maxillomandibular Relationship Determination to Clinical Implementation for Digital Functional-Esthetic Rehabilitation in Severe Generalised Tooth Surface Loss.

Abstract

Objective: The purpose of this article is to present a digital workflow to resolve functional-esthetic conflicts in severe generalised tooth surface loss (TSL).

Clinical considerations: Key challenges in TSL involved compromised structural integrity of the dentition, necessitating precise occlusal rehabilitation to achieve a stable mandibular position and occlusion. The virtual patient-derived protocol introduced two technical advancements: (1) maxillomandibular relationship (MMR) determination through jaw kinematics capture, and (2) dynamic anterior guidance optimization via jaw motion tracking and dynamic articulation simulation. This digital workflow eliminates the need for conventional physical impressions and analog articulator mounting, reducing clinical adjustment requirements compared to traditional techniques.

Conclusions: The implemented digital workflow successfully restored occlusal function and esthetics through synchronized virtual planning and guided reconstruction, achieving stable occlusion and reproducible centric relation in severe TSL. Final restorations demonstrated high morphological congruence with digital diagnostic designs.

Clinical significance: Utilizing a virtual MMR determination through jaw motion tracking and a computer-guided anterior guidance reconstruction enables systematic diagnostic analysis/design, treatment planning, and prosthodontic fabrication. The digital workflow demonstrates superior clinical efficacy in anatomical preservation, functional reproducibility, and esthetic rehabilitation for severe TSL management.