Integrating conventional and CAD/CAM digital techniques for establishing canine protected articulation: A clinical...

Canine protected articulation is widely accepted for patients requiring extensive oral rehabilitation. Computer-aided design and computer-aided manufacturing (CAD/CAM) restorations have been primarily designed in occlusion at the maximum intercuspal position. Designing a virtual articulator that is capable of accepting excursive occlusal records and duplicating the mandibular movements is a challenge for CAD/CAM technology. Modifying tooth shape using composite resin trial restorations to produce esthetic results and later scanning the modified teeth to create milled crowns is becoming a popular use of the CAD/CAM technology. This report describes a technique that combines conventional and CAD/CAM prosthodontic techniques for milling crowns for canine teeth that are designed to establish or improve canine protected articulation. This technique involves designing and fabricating interim restorations based on diagnostic waxing, scanning the designs intraorally, and storing them in software as pretreatment digital records. The scanned designs are then applied to the digital representation of the prepared teeth to fabricate the definitive restorations.