Digital Workflow For The Rehabilitation of The Excessively Worn Dentition
Digital Workflow For The Rehabilitation of The Excessively Worn Dentition
Digital Workflow For The Rehabilitation of The Excessively Worn Dentition
treatment and esthetic analysis as well as an treatment rather than on the treatment as a
important communication tool among the whole. The presented case provides a step-
clinician, the dental technician/s, and the by-step description of the treatment of an
patient. Intraoral scanners (IOSs) used for excessively worn dentition with the aid of
computer-assisted impressions are predict- the digital workflow.
able and fast tools for digitizing and manu-
facturing small-unit reconstructions.24-27 Case presentation
The next step of the digital workflow is
the processing/planning of the collected A 38-year-old male patient presented for
data to create the virtual patient, finalize a consultation and treatment. His chief com-
treatment plan or design a restoration. Data plaint was the overall unpleasant appear-
obtained from different acquisition tools ance of his teeth, which were extremely
(eg, intraoral scans, CBCT images, or patient short and dark. Due to his tooth appear-
photographs superimposed onto model ance, the patient said that he avoided smil-
scans) can be merged or superimposed us- ing and socializing. In addition, he stated
ing specific planning software to enhance that he had several old restorations that re-
the information on the computer screen for quired replacement (Fig 2).
the clinician or dental technician.24,28 The patient’s medical history revealed
The last step of the digital workflow is no significant general conditions or aller-
the treatment and fabrication, where the gies. He was a heavy smoker (30 cigarettes
planned treatment or production of the per day) and consumed approximately 1.5
prosthesis takes place by means of CAM. liters of carbonated soft drinks per day. He
The CAD data is imported into the CAM was not under any medication. The patient’s
software to manufacture the appliances dental history revealed several restorations
and/or restorations.24 delivered over the years, the extraction of
To date, the digital workflow for the re- tooth 46, and extreme wear possibly asso-
habilitation of worn dentition has focused ciated with his lifestyle. His oral hygiene was
more or less on the implementation of average and he did not visit a dentist on a
chairside technologies to deliver segmental regular basis.
a b
Fig 2 Initial extraoral and smile photographs. (a) The teeth appear barely visible during a social smile. (b) A forced smile reveals short and
discolored maxillary and mandibular teeth, reflecting a jeopardized esthetic appearance.
b c
d e
Fig 3a to e nterior, vestibular, and occlusal views of the initial situation. The teeth appear extremely worn and
discolored, along with multiple insufficient restorations and secondary caries.
Fig 4a and b Periodontal charting depicting probing depths, bleeding on probing (BOP), attachment loss (AL),
attached gingiva (AG), and recession (RZ). No furcation involvement was recorded.
TREATMENT OPTIONS
Parameters Composite Crown & FDP Minimally invasive
Patient comfort + + +
Quality of life + + +
Esthetics +/– + +
Invasiveness + – +
Fabrication complexity +/– + +
Extensibility/reparability + – –
Oral hygiene performance + +/– +
Economics + – –
Long-term clinical performance – + +
+ Advantage; – Disadvantage
Fig 5a and b The radiographic assessment revealed insufficient root canal therapy on teeth 16 and 25 as well as a
periapical lesion on tooth 16.
for the different options to assist in the se- patient-relevant parameters in the final re-
lection of the most appropriate one for habilitation. While some clinicians advocate
each specific patient. this approach as being an esthetic, fast, eco-
nomical, and reliable one, the final outcome
Rehabilitation with direct resin-based solely depends on the clinician’s skills, and
restorations in many cases yields a compromised re-
The use of direct resin-based restorations sult.31-33 Additionally, long-term data to sup-
for the rehabilitation of extremely worn port the performance of such restorations
dentitions has been discussed in the litera- are not available. In fact, most studies in the
ture and advocated as the most conserva- literature are case series. Overall, the surviv-
tive treatment option.29,30 While there are al rates for vertical bite reconstructions us-
several composite resin systems available ing composite resin are between 93.1% to
that show favorable characteristics in terms 98% after 3.3 to 5.5 years (Table 2).16,34,35
of resistance, color stability, and handling,
a full-mouth rehabilitation using this tech- Conventional crowns and FPDs
nique is not only difficult but also does not It is widely accepted that a fixed prosthetic
guarantee the accurate inclusion of the rehabilitation shows a very good long-term
Table 2 An overview of the mid- and long-term outcomes of various treatment options favors ceramic-based over
composite-based restorations
Fig 6 Treatment steps and sequence for both clinical and laboratory sessions with an emphasis on the digital workflow.
Fig 7a and b The patient-relevant references were registered relative to the natural head position and the horizontal (zero) plane. The
registered angle of the ala-tragus plane to the horizontal plane was set in the articulator by modifying the registration table inclination
accordingly.
a manipulation of the VDO considered. Ac- smiling (Fig 8). With the delivered splint, the
cordingly, and prior to tooth preparation, a patient’s comfort with the new VDO was
noninvasive try-in of this manipulation was evaluated, and the wear patterns helped
facilitated using an occlusal splint. The splint to track the course of reprogramming the
was designed using the same CAD soft- dynamics. The extent of the wear serves as
ware, taking into consideration the amount an aid to identify the degree of parafunction
of space needed for the manipulation of (Fig 9).
the VDO, and was milled out of a polymeth- As the clinical crown height of the max-
yl methacrylate (PMMA) block. It was then illary teeth was deemed insufficient to pro-
delivered to the patient, who was asked to vide an appropriate retention, a selective
use it for a period of a few weeks. The ana- crown-lengthening procedure focusing
tomical design of the splint from the facial on the palatal aspect of the teeth was per-
aspect improved the esthetic appearance formed (Fig 10). A healing period of 6 to
and restored the patient’s confidence when 9 months is usually recommended after
a b
a b
Fig 9a and b The extent and pattern of wear of the PMMA splint helps to identify the degree of parafunction, ie, bruxism.
a b
Fig 10a and b Crown lengthening surgery was performed to increase the clinical crown height of the maxillary teeth. Tooth 16 was
extracted at the same time that the crown lengthening surgery took place.
a b
such a procedure in the anterior zone to After the successful test drive of the ma-
ensure proper postsurgical soft tissue matu- nipulation of the VDO, the virtual design
ration and stability.49-55 of the shell-type provisional restorations in
In order to provide the dental techni- both jaws was carried out. The provision-
cian with more information and to improve al restorations were milled out of a PMMA
communication, a face scanner (Face Hunt- block in a 5+1-axis milling machine (M5;
er; Zirkonzahn) was used to deliver infor- Zirkonzahn), after which they were further
mation about the integration between the refined and characterized manually by the
facial soft tissue and the teeth at different dental technician. A centering device made
viewing positions. A registration of the jaw of a reinforced acetate matrix with a rigid
relationship with the face was performed support (hard palate) was fabricated to po-
with a registration fork, which utilizes soft- sition the provisional restorations accurately
ware-specific markers that help to align the in the oral cavity (Fig 12). After tooth prepara-
different data sets of the jaws (model scan) tion and prior to the relining procedure, the
and face scans (Fig 11). provisional restorations were placed in the
a b c
d e
f g
Fig 12a to g PMMA shell-type provisional restorations were milled for the maxillary and mandibular teeth. The centering device helped to
secure an accurate position of the restorations along with the relining procedure in both jaws.
a b
c d
Fig 13a to d Delivered provisional restorations in both jaws. The correct registration and mounting procedure,
along with the intraoral fitting procedure, is reflected in the accuracy of the resulting occlusal scheme. The esthetic
outcome after delivery of the provisional restorations and its impact on the overall appearance of the patient was
obvious. The amount of VDO manipulation introduced to achieve proper esthetics and facilitate sufficient material
bulk thickness is shown.
centering device and filled with a silicone interferences were verified and eliminated
paste (Fit Checker; GC Dental). Then, with in the provisional restorations of the man-
the help of the centering device, the restor- dible using a centering device. Then, the
ations were placed on the prepared teeth relining procedure for the mandibular pro-
to verify the fit on the anatomical landmarks visional restorations was performed by clos-
(eg, the soft tissue of the hard palate and ing in centric relation, while the properly
gingiva). The provisional restorations were fitted provisional restorations in the maxilla
then removed and checked for interferenc- remained on the maxillary teeth to guide
es showing through the silicone paste that the procedure. Finally, the provisional res-
might prevent the achievement of a proper torations in both jaws were removed, fin-
fit during the relining procedure. After the ished, polished, and delivered using a tem-
elimination of interferences, the aforemen- porary cement (Fig 13).
tioned procedure was repeated. Three weeks after the delivery of the
The next step was to perform the relining provisional restorations, the final impression
procedure using a PMMA resin-based mate- was carried out with custom-made impres-
rial with the aid of the centering device. Af- sion trays and polyether-based impression
ter the relining material had set, the relined material (Impregum Penta DuoSoft; 3M
provisional restorations were retained in the ESPE). The master casts were poured and
maxilla. In a similar manner to the maxilla, mounted with the aid of the PlaneFinder
c e
f g
system. The casts and the maxillomandib- delivered to the patient for a period of at
ular relationship were then digitized and least 1 week. During this period, esthetics,
virtually mounted, as previously explained. phonetics, function, and comfort were eval-
Following this, the CAD of the restorations uated, and the patient had ample time to
was performed (Fig 14). Based on the virtual self-test the design and provide feedback.
design, prototypes of the final restorations Any necessary modifications were per-
were milled out of a PMMA resin block and formed directly on the prototypes (Fig 15).
a b
Fig 15a and b Prototypes of the final restorations were used to test drive esthetics, phonetics, function, and comfort.
c d e
Fig 16a to e The final restorations were composed of milled fully anatomical translucent zirconia crowns and FPDs with individual charac-
terization to mimic the natural tooth appearance.
Fig 17a to d Anterior, vestibular, and occlusal images of the final Fig 18 Final panoramic radiograph after the delivery of the
restorations after delivery. The VDO, esthetics, and harmony were restorations.
restored properly. The amount of VDO manipulation can be
identified.
a b
Fig 19a and b The new restorations implemented a canine-protected dynamic occlusion. The patient was instructed to wear the night
guard every night.
a b
Fig 20a and b Extraoral and smile line photographs after the delivery of the final restorations.
central incisors relevant to the position of 4 weeks to allow for proper adaptation. This
the lower lip.15 This procedure guides the is necessary, as these removable appliances
full-mouth diagnostic wax-up, which is the are not worn constantly every day. Also, the
key to setting the amount of VDO manip- test drive allows for the evaluation of the re-
ulation needed to accommodate the new programming of the dynamics and pattern
tooth length. of parafunction.22,56
Following this step, the occlusal splint While most cases require a coronal
can be manufactured accordingly. In addi- lengthening of the teeth, a surgical crown
tion to the homogenous distribution of oc- lengthening is often needed to achieve a
clusal contacts, the splint should incorpo- clinical crown height of at least 3 mm for
rate canine-protected dynamic occlusion. proper retention in cases of extreme wear.
Although no clear guidelines have been For surgical crown lengthening, it is import-
established to date, the authors recom- ant to follow the guidelines for establishing
mend that the period of the test drive of the a healthy biologic width without compro-
new VDO via the splint should be at least mising the esthetic outcome (black triangle,
emergence profile irregularities) as well as facial midline, horizontal (zero) plane, etc.
to meet the restorative challenges (adhesive Therefore, the use of physical casts mount-
contraindications on exposed root surfac- ed in a real articulator remains the method
es).49-55,57 An alternative method to crown of choice in order to include patient-rele-
lengthening is orthodontic extrusion. How- vant planes and references. It can be argued
ever, due to its long duration and the diffi- that STL data from IOSs can be used to print
culty of performing it when multiple teeth models that can be used for the conven-
are involved, this treatment option is not tional mounting procedure. Nevertheless,
usually chosen by clinicians and patients. 3D printing of full-mouth models still does
The digital workflow provides numer- not show sufficient accuracy.62 Many clini-
ous advantages over the conventional cians use printed models not for verifying
approach. These can be summarized as occlusal and proximal contacts, but only
improved communication, better coordi- for holding the restorations. Therefore, for
nated and more efficient treatment (ie, few- full-arch cases, the present authors believe
er appointments), and ultimately, more con- that the most accurate method currently is
trolled and predictable outcomes. Despite to perform conventional impressions and
its advantages, the implementation of the produce conventional casts, which can be
digital workflow for full-arch rehabilitations later digitized using a desktop scanner. The
is still limited. Apart from initial investment conventionally mounted casts can then be
costs and the duration of the learning curve, digitized using the individual virtual articula-
the limitations of use relate to several other tion method to transfer all patient-relevant
factors, one of which is the limitations of the references into the virtual space.62
current technology. For example, the use of While virtual articulated models facilitate
IOSs for full-arch digital impressions, when better communication and ease of work for
compared with conventional impressions, the dental technician, important information
still does not result in sufficiently accurate remains unavailable, namely, the relation-
data.58-60 Available studies on the accuracy ship to the soft anatomical structures. Here,
of IOSs for full-arch scans remain limited to the dental technician can be provided with
a small number of devices. This means that 2D photographs that can be superimposed
the results cannot be generalized to all IOSs, onto the 3D virtual models. Most CAD soft-
and at the same time show unacceptable ware is capable of performing this match-
deviations. Workarounds that have been ing procedure, which facilitates the deter-
suggested to overcome full-arch scans is to mination of tooth display at rest or during
segment the case, which is not a feasible smiling as well as the facial midline. Digital
option when it comes to ease of the treat- smile design features are known to use this
ment process. Even with a sufficiently ac- approach. However, the superimposition of
curate IOS, a further issue is how to mount 2D photographs onto 3D virtual models is
the virtual models to include all planes and practically a combination between a plane
patient-relevant references. Here, inaccu- and 3D data sets and lacks significant infor-
racies in virtual occlusal contacts that do mation about the anterior-posterior posi-
not represent a clinical reality are a further tion as well as the inclination of the teeth.
factor of concern.61 Moreover, it is import- Therefore, this type of data superimposition
ant to mention that IOSs implement the so- can be considered as a limited improve-
called advanced virtual articulation, which ment of communication. Clearly, it is bet-
does not include important references for ter to superimpose 3D face scan data onto
the rehabilitation such as occlusal plane, the 3D data of the model scan. In this way,
information about the anterior-posterior shows improved optical properties and en-
position and the inclination of teeth can be hanced esthetics.
viewed and incorporated into the CAD. Al- Regardless of the restorative material
though the available face scanners are static used, the wear resistance property as well as
and do not capture mobility, mimics cannot the wear of the antagonist teeth, especially
be incorporated. Consequently, multiple with patients who experience parafunction,
face scans with different positions, such as remains an important criterion for selection.
mouth closed, social smile, extreme smile, While the microstructure of the material has
etc, are required to incorporate more infor- a smaller effect, surface roughness has the
mation for the CAD procedure. In addition, greatest impact on the wear of both the
the current CAD software does not feature material and the antagonist teeth.65 Regular
the so-called morphing function, meaning grinding procedures are known to produce
that facial soft tissue structures (lips) will not an average surface roughness that easily ex-
adapt according to the new tooth position ceeds 1 μm, whereas that of polished and/
in the CAD data. Lastly, knowledge is still or glazed ceramic surfaces is as low as 0.06
limited regarding the accuracy of face scan to 0.2 μm.65-67 Hence, intraoral occlusal ad-
data and that of the superimposition with justments of ceramic restorations should
model scan or intraoral scan data.63,64 always be avoided. This can be achieved
Along with the improvement of CAM through the use of prototypes to test the
procedures, new restorative materials with design of the final restorations and to make
improved physical and optical properties are any necessary adjustments before finalizing
being utilized. Currently, lithium disilicate or the design and manufacturing of the restor-
zirconia-based ceramics are the most wide- ations. If needed, however, occlusal adjust-
ly used materials to manufacture ceramic ments should only be performed with fine-
restorations. As mentioned earlier, while grain diamond burs and must be followed
the material selection remains based main- by a thorough polishing sequence.
ly on the clinician’s preference, the current
trend advocates for the use of monolithic Conclusion
restorations. To further enhance esthetics,
veneering ceramics limited to the facial as- The implementation of the digital workflow
pect of the restorations can be considered. aims to provide a faster and more predict-
For zirconia-based materials, the authors able treatment. Despite the advances in
recommend not to extend the veneering technology, a combination between digital
ceramic to the incisal edge to avoid loads and conventional procedures is still needed
that may lead to chip off. Rather, the design for the treatment of complex cases. For ex-
of the restoration should facilitate protec- cessive wear cases, the workflow described
tion of the incisal edge with the zirconia here enhances communication among the
material. While the traditional opaque zir- treatment team and the patient and ensures
conia materials may jeopardize the esthetic a predictable outcome, provided that the
outcome at the incisal edge area, the new team is well versed in all the elements re-
generation of translucent zirconia materials lated to the technologies and the workflow.
References
1. Van’t Spijker A, Rodriguez JM, Kreulen a minimally invasive prosthetic procedure applications. In: Att W, Witkowski S, Strub J
CM, Bronkhorst EM, Bartlett DW, Creugers (MIPP). Int J Esthet Dent 2016;11:16–35. (eds). Digital Workflow in Recon- structive
NH. Prevalence of tooth wear in adults. Int J 15. Fradeani M, Barducci G, Bacherini L, Dentistry. Berlin: Quintessenz, 2019:9–42.
Prosthodont 2009;22:35–42. Brennan M. Esthetic rehabilitation of a 27. Witkowski S. Laboratory desktop scan-
2. Schlueter N, Luka B. Erosive tooth severely worn dentition with minimally inva- ners. In: Att W, Witkowski S, Strub J (eds).
wear – a review on global prevalence and sive prosthetic procedures (MIPP). Int J Peri- Digital Workflow in Reconstructive Dentistry.
on its prevalence in risk groups. Br Dent J odontics Restorative Dent 2012;32:135–147. Berlin: Quintessenz, 2019:43–52.
2018;224:364–370. 16. Hamburger JT, Opdam NJ, Bronkhorst 28. Vuck A, Alsahaf A, Emmanoulidi N, Bre-
3. Abrahamsen TC. The worn dentition EM, Kreulen CM, Roeters JJ, Huysmans MC. zavscek M. Digital assessment tools and data
– pathognomonic patterns of abrasion Clinical performance of direct composite manipulation. In: Att W, Witkowski S, Strub
and erosion. Int Dent J 2005;55(4 suppl restorations for treatment of severe tooth J (eds). Digital Workflow in Reconstructive
1):268–276. wear. J Adhes Dent 2011;13:585–593. Dentistry. Berlin: Quintessenz, 2019:125–54.
4. The Glossary of Prosthodontic Terms: 17. Johansson A, Johansson AK, Omar R, 29. Coelho-de-Souza FH, Gonçalves DS,
Ninth Edition. J Prosthet Dent 2017;117: Carlsson GE. Rehabilitation of the worn Sales MP,P et al. Direct anterior compos-
e1–e105. dentition. J Oral Rehabil 2008;35:548–566. ite veneers in vital and non-vital teeth: a
5. Bartlett D, O’Toole S. Tooth wear and ag- 18. Loomans B, Opdam N. A guide to man- retrospective clinical evaluation. J Dent
ing. Aust Dent J 2019;64(suppl 1):S59–S62. aging tooth wear: the Radboud philosophy. 2015;43:1330–1336.
6. Johansson A, Omar R. Identification and Br Dent J 2018;224:348–356. 30. Gresnigt MM, Kalk W, Ozcan M. Ran-
management of tooth wear. Int J Prostho- 19. Mesko ME, Sarkis-Onofre R, Cenci MS, domized controlled split-mouth clinical
dont 1994;7:506–516. Opdam NJ, Loomans B, Pereira-Cenci T. trial of direct laminate veneers with two
7. Kanzow P P, Wegehaupt FJ, Attin T, Wie- Rehabilitation of severely worn teeth: a micro-hybrid resin composites. J Dent
gand A. Etiology and pathogenesis of dental systematic review. J Dent 2016;48:9–15. 2012;40:766–775.
erosion. Quintessence Int 2016;47:275–278. 20. Turner KA, Missirlian DM. Restoration 31. Vailati F, Belser UC. Full-mouth adhesive
8. Hermont AP, P Oliveira PA, Martins CC, Pai- of the extremely worn dentition. J Prosthet rehabilitation of a severely eroded denti-
va SM, Pordeus IA, Auad SM. Tooth erosion Dent 1984;52:467–474. tion: the three-step technique. Part 3. Eur J
and eating disorders: a systematic review and 21. Varma S, Preiskel A, Bartlett D. The Esthet Dent 2008;3:236–257.
meta-analysis. PLoS One 2014;9:e111123. management of tooth wear with crowns 32. Vailati F, Belser UC. Full-mouth adhesive
9. LeResche L. Epidemiology of temporo- and indirect restorations. Br Dent J rehabilitation of a severely eroded denti-
mandibular disorders: implications for the 2018;224:343–347. tion: the three-step technique. Part 2. Eur J
investigation of etiologic factors. Crit Rev 22. Abduo J, L Lyons K. Clinical consid- Esthet Dent 2008;3:128–146.
Oral Biol Med 1997;8:291–305. erations for increasing occlusal vertical 33. Vailati F, Belser UC. Full-mouth adhesive
10. Muts EJ, van Pelt H, Edelhoff D, Krejci dimension: a review. Aust Dent J 2012;57: rehabilitation of a severely eroded dentition:
I, Cune M. Tooth wear: a systematic review 2–10. the three-step technique. Part 1. Eur J Esthet
of treatment options. J Prosthet Dent 23. Brezavscek M, Lamott U, Att W. Treat- Dent 2008;3:30–44.
2014;112:752–759. ment planning and dental rehabilitation 34. Attin T, Filli T, Imfeld C, Schmidlin PR.
11. Loomans BAC, Wetselaar P, P Opdam of a periodontally compromised partially Composite vertical bite reconstructions in
NJM. European statement of consensus edentulous patient: a case report – Part I. Int eroded dentitions after 5.5 years: a case
regarding the treatment of severe tooth J Esthet Dent 2014;9:402–411. series. J Oral Rehabil 2012;39:73–79.
wear. [in Dutch]. Ned Tijdschr Tandheelkd 24. Att W. Digital workflow in reconstructive 35. Ramseyer ST, Helbling C, Lussi A.
2018;125:223–231. dentistry: an introduction. In: Att W, Witkow- Posterior vertical bite reconstructions of
12. Calamita M, Coachman C, Sesma N, Kois ski S, Strub J (eds). Digital Workflow in Re- erosively worn dentitions and the “Stamp
J. Occlusal vertical dimension: treatment constructive Dentistry. Berlin: Quintessenz, Technique” – a case series with a mean ob-
planning decisions and management consid- 2019:1–8. servation time of 40 months. J Adhes Dent
erations. Int J Esthet Dent 2019;14:166–181. 25. Fonseca M, Cepa S, Rauberger H, 2015;17:283–289.
13. Chu FC, Siu AS, Newsome PR, Chow Blattner S, Att W. Optical face scanners. 36. P Pjetursson BE, Bragger U, Lang NP, P
TW, Smales RJ. Restorative management of In: Att W, Witkowski S, Strub J (eds). Digital Zwahlen M. Comparison of survival and
the worn dentition: 4. Generalized tooth- Workflow in Reconstructive Dentistry. Berlin: complication rates of tooth-supported fixed
wear. Dent Update 2002;29:318–324. Quintessenz, 2019:53–74. dental prostheses (FDPs) and implant-sup-
14. Fradeani M, Barducci G, Bacherini L. Es- 26. Att W, Lamprinos C, Al-Ghamdi Y. ported FDPs and single crowns (SCs). Clin
thetic rehabilitation of a worn dentition with Intraoral scanners: current status and future Oral Implants Res 2007;18(suppl 3):97–113.
37. P
Pjetursson BE, Sailer I, Makarov NA, formance of cast gold vs ceramic partial 58. Goracci C, Franchi L, Vichi A, Ferrari
Zwahlen M, Thoma DS. All-ceramic or crowns. Clin Oral Investig 2007;11:345–352. M. Accuracy, reliability, and efficiency of
metal-ceramic tooth-supported fixed 46. Guess PC, Selz CF, Steinhart YN, Stampf intraoral scanners for full-arch impressions:
dental prostheses (FDPs)? A systematic S, Strub JR. Prospective clinical split-mouth a systematic review of the clinical evidence.
review of the survival and complication study of pressed and CAD/CAM all-ceramic Eur J Orthod 2016;38:422–428.
rates. Part II: Multiple-unit FDPs. Dent Mater partial-coverage restorations: 7-year results. 59. Patzelt SB, Emmanouilidi A, Stampf S,
2015;31:624–639. Int J Prosthodont 2013;26:21–25. Strub JR, Att W. Accuracy of full-arch scans
38. PPjetursson BE, Sailer I, Makarov NA, 47. Wiedhahn K, Kerschbaum T, Fasbinder using intraoral scanners. Clin Oral Investig
Zwahlen M, Thoma DS. Corrigendum to DF. Clinical long-term results with 617 Cerec 2014;18:1687–1694.
“All-ceramic or metal-ceramic tooth-sup- veneers: a nine-year report. Int J Comput 60. Wesemann C, Muallah J, Mah J, Bu-
ported fixed dental prostheses (FDPs)? A Dent 2005;8:233–246. mann A. Accuracy and efficiency of full-arch
systematic review of the survival and com- 48. Att W, Witkowski S, Strub J. Virtual regis- digitalization and 3D printing: a compari-
plication rates. Part II: Multiple-unit FDPs” tration, mounting, and articulation. In: Att W, son between desktop model scanners, an
[Dental Mater 31 (6) (2015) 624–639]. Dent Witkowski S, Strub J (eds). Digital Workflow intraoral scanner, a CBCT model scan, and
Mater 2017;33:e48–e51. in Reconstructive Dentistry, 2019:105–124. stereolithographic 3D printing. Quintes-
39. Sailer I, Makarov NA, Thoma DS, 49. Bragger U, Lauchenauer D, Lang NP. sence Int 2017;48:41–50.
Zwahlen M, P Pjetursson BE. All-ceramic Surgical lengthening of the clinical crown. 61. Gintaute A, Keeling AJ, Osnes CA,
or metal-ceramic tooth-supported fixed J Clin Periodontol 1992;19:58–63. Zitzmann NU, Ferrari M, Joda T. Precision
dental prostheses (FDPs)? A systematic 50. Hempton TJ, Dominici JT. Contempo- of maxillo-mandibular registration with in-
review of the survival and complication rary crown-lengthening therapy: a review. traoral scanners in vitro. J Prosthodont Res
rates. Part I: Single crowns (SCs). Dent Mater J Am Dent Assoc 2010;141:647–655. 2020;64:114–119.
2015;31:603–623. 51. Kaldahl WB, Kalkwarf KL, Patil KD, Molvar 62. Patzelt SB, Bishti S, Stampf S, Att W. Ac-
40. Sailer I, Makarov NA, Thoma DS, MP,
P Dyer JK. Long-term evaluation of peri- curacy of computer-aided design/comput-
Zwahlen M, P Pjetursson BE. Corrigendum to odontal therapy: I. Response to 4 therapeutic er-aided manufacturing-generated dental
“All-ceramic or metal-ceramic tooth- sup- modalities. J Periodontol 1996;67:93–102. casts based on intraoral scanner data. J Am
ported fixed dental prostheses (FDPs)? A 52. Lindhe J, Socransky SS, Nyman S, Dent Assoc 2014;145:1133–1140.
systematic review of the survival and com- Westfelt E. Dimensional alteration of the 63. Piedra-Cascon W, Methani MM, Que-
plication rates. Part I: Single crowns (SCs)” periodontal tissues following therapy. Int J sada-Olmo N, Jimenez-Martinez MJ, Revil-
[Dental Materials 31 (6) (2015) 603–623]. Periodontics Restorative Dent 1987;7:9–21. la-Leon M. Scanning accuracy of nondental
Dent Mater 2016;32:e389–e90. 53. Olsen CT, Ammons WF, van Belle G. A structured light extraoral scanners com-
41. Fabbri G, Zarone F, Dellificorelli G, et longitudinal study comparing apically re- pared with that of a dental-specific scanner
al. Clinical evaluation of 860 anterior and positioned flaps, with and without osseous [epub ahead of print 19 July 2020]. J Pros-
posterior lithium disilicate restorations: ret- surgery. Int J Periodontics Restorative Dent thet Dent 2020;S0022-3913(20)30263-8.
rospective study with a mean follow-up of 1985;5:10–33. 64. Piedra-Cascón W, Meyer MJ, Methani
3 years and a maximum observational peri- 54. Pontoriero R, Carnevale G. Surgical MM, Revilla-León M. Accuracy (trueness and
od of 6 years. Int J Periodontics Restorative crown lengthening: a 12-month clini- precision) of a dual-structured light facial
Dent 2014;34:165–177. cal wound healing study. J Periodontol scanner and interexaminer reliability [epub
42. Fradeani M, Redemagni M, Corrado 2001;72:841–848. ahead of print 6 Jan 2020]. J Prosthet Dent
M. Porcelain laminate veneers: 6- to 12- 55. Smith DH, Ammons WF, Jr, Van Belle 2020;S0022-3913(19)30689-4.
year clinical evaluation – a retrospective G. A longitudinal study of periodontal status 65. Aldegheishem A, Alfaer A, Brezavšček
study. Int J Periodontics Restorative Dent comparing osseous recontouring with flap M, Vach K, Eliades G, Att W. Wear behav-
2005;25:9–17. curettage. I. Results after 6 months. J Peri- ior of zirconia substrates against different
43. Layton DM, Walton TR. The up to 21-year odontol 1980;51:367–375. antagonist materials. Int J Esthet Dent
clinical outcome and survival of feldspathic 56. Turp JC, Greene CS, Strub JR. Dental 2015;10:468–485.
porcelain veneers: accounting for clustering. occlusion: a critical reflection on past, 66. Park JH, Park S, Lee K, Yun KD, Lim HP.
Int J Prosthodont 2012;25:604–612. present and future concepts. J Oral Rehabil Antagonist wear of three CAD/CAM ana-
44. Barghi N, Berry TG. Clinical evaluation 2008;35:446–453. tomic contour zirconia ceramics. J Prosthet
of etched porcelain onlays: a 4-year report. 57. Marzadori M, Stefanini M, Sangiorgi M, Dent 2014;111:20–29.
Compend Contin Educ Dent 2002;23: Mounssif I, Monaco C, Zucchelli G. Crown 67. Preis V, Weiser F, Handel G, Rosentritt
657–664. lengthening and restorative procedures M. Wear performance of monolithic dental
45. Federlin M, Wagner J, Manner T, Hiller in the esthetic zone. Periodontol 2000 ceramics with different surface treatments.
KA, Schmalz G. Three-year clinical per- 2018;77:84–92. Quintessence Int 2013;44:393–405.