Digital Esthetic-Functional Occlusal Reconstruction In Tmds-Related Dentition Defects

This study aims to assess the clinical efficacy of digital technology in cases of secondary occlusal reconstruction. A patient who underwent traditional occlusal reconstruction 10 years previously received secondary reconstruction using a full-mouth digital approach. Preoperative procedures included recording three-dimensional mandibular movement trajectories, dynamically assessing the temporomandibular joints (TMJ) and jaw position relationships, integrating cone-beam computed tomography (CBCT) data, and designing the full-mouth occlusal morphology via digital technology. A dental implant guide was fabricated for anterior dental implantation. Polymethyl methacrylate (PMMA) provisional crowns were milled according to the design data for trial fitting, followed by reassessment of mandibular movement trajectories, the stability of the intercuspal position (ICP), and the presence of dynamic occlusal interferences. Final restorations were fabricated based on the design data and clinical feedback from the provisional restorations to achieve esthetic and functional occlusal reconstruction. During digital secondary reconstruction, an insufficient occlusal vertical dimension from the original restoration was identified. The occlusal condition was adjusted dynamically in three dimensions. Postoperative data were matched with preoperative and design data to analyze the accuracy of occlusal reconstruction. Digital technology precisely optimizes and addresses limitations in traditional occlusal reconstruction, enabling the accurate realization of both functional and esthetic outcomes.