Journal of Prosthetic Dentistry

Cast-free modified digital twin-stage technique for complete mouth rehabilitation: A dental technique


      A technique for making a computer-aided design (CAD) of a complete arch restoration with a fully digital workflow is described. The virtual definitive cast was mounted on a virtual articulator, and the CAD was made in 2 stages: the anterior teeth followed by the posterior teeth. The settings of the virtual articulator were adjusted to make the CAD of anterior teeth by following Hobo and Takayama’s twin-stage philosophy to ensure disclusion of the posterior teeth during eccentric movements. Posterior teeth were designed in a second stage guided by the definitive CAD of the anterior teeth, determined by the mandibular movements of the virtual articulator.
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        • Ferrando-Cascales Á.
        • Astudillo-Rubio D.
        • Pascual-Moscardó A.
        • Delgado-Gaete A.
        A facially driven complete-mouth rehabilitation with ultrathin CAD-CAM composite resin veneers for a patient with severe tooth wear: a minimally invasive approach.
        J Prosthet Dent. 2020; 123: 537-547
        • Schlichting L.H.
        • Resende T.H.
        • Reis K.R.
        • Magne P.
        Simplified treatment of severe dental erosion with ultrathin CAD-CAM composite occlusal veneers and anterior bilaminar veneers.
        J Prosthet Dent. 2016; 116: 474-482
        • Chronopoulos V.
        • Maroulakos G.
        • Tsoutis K.
        • Stathopoulou P.
        • Nagy W.W.
        Complete mouth rehabilitation and gastroesophageal reflux disease: conventional and contemporary treatment approaches.
        J Prosthet Dent. 2017; 117: 1-7
        • Abduo J.
        Safety of increasing vertical dimension of occlusion: a systematic review.
        Quintessence Int. 2012; 43: 369-380
        • Abduo J.
        • Lyons K.
        Clinical considerations for increasing occlusal vertical dimension: a review.
        Aust Dent J. 2012; 57: 2-10
        • Fraile C.
        • Ferreiroa A.
        • Romeo M.
        • Alonso R.
        • Pradíes G.
        Clinical study comparing the accuracy of interocclusal records, digitally obtained by three different devices.
        Clin Oral Investig. 2022; 26: 1957-1962
        • Lepidi L.
        • Galli M.
        • Mastrangelo F.
        • et al.
        Virtual articulators and virtual mounting procedures: where do we stand?.
        J Prosthodont. 2021; 30: 24-35
        • Lepidi L.
        • Suriano C.
        • Wang H.L.
        • Granata S.
        • Joda T.
        • Li J.
        Digital fixed complete-arch rehabilitation: from virtual articulator mounting to clinical delivery.
        J Prosthet Dent. 2022; 127: 398-403
        • Li J.
        • Att W.
        • Chen Z.
        • Lepidi L.
        • Wang H.L.
        • Joda T.
        Prosthetic articulator-based implant rehabilitation virtual patient: a technique bridging implant surgery and reconstructive dentistry.
        J Prosthet Dent. 30 October 2021; ([Epub ahead of print])
        • Lepidi L.
        • Chen Z.
        • Ravida A.
        • Lan T.
        • Wang H.L.
        • Li J.
        A full-digital technique to mount a maxillary arch scan on a virtual articulator.
        J Prosthodont. 2019; 28: 335-338
        • Hobo S.
        • Takayama H.
        Twin-stage procedure. Part 1: a new method to reproduce precise eccentric occlusal relations.
        Int J Periodontics Restorative Dent. 1997; 17: 112-123
        • Hobo S.
        • Takayama H.
        Twin-stage procedure. Part 2: a clinical evaluation test.
        Int J Periodontics Restorative Dent. 1997; 17: 457-463
        • Witkop C.J.
        Amelogenesis imperfecta, dentinogenesis imperfecta and dentin dysplasia revisited: problems in classification.
        J Oral Pathol Med. 1988; 17: 547-553
        • Bergstrom G.
        On the reproduction of dental articulation by means of articulators.
        Acta Odontol Scand Suppl. 1950; 9: 3-149
        • Iwauchi Y.
        • Tanaka S.
        • Kamimura-Sugimura E.
        • Baba K.
        Clinical evaluation of the precision of interocclusal registration by using digital and conventional techniques.
        J Prosthet Dent. 25 March 2021; ([Epub ahead of print])
        • Ries J.M.
        • Grünler C.
        • Wichmann M.
        • Matta R.E.
        Three-dimensional analysis of the accuracy of conventional and completely digital interocclusal registration methods.
        J Prosthet Dent. 19 April 2021; ([Epub ahead of print])