Fabrication of fixed prosthesis by employing functionally generated path technique and dual scan technique in a tardive dyskinesia patient: a case report

초록

Tardive dyskinesia is an involuntary neurological movement disorder caused by long-term use of dopamine receptor-blocking drugs leading to dental implications like uncontrolled gnashing and grinding of teeth which in turn imperil the oral rehabilitation procedures as the excessive load increases the risk of prosthesis fracture. A 40-year male with a medical history of tardive dyskinesia visited the hospital to receive oral rehabilitation for missing maxillary anterior teeth. After the oral examination, tooth preparation was done on teeth 13, 15, and 23. After that silicon impression was made and the gypsum cast was digitalized using a desktop scanner and an interim prosthesis was fabricated by milling a resin block. During the try-in, the occlusal one-third of the interim prosthesis was trimmed, and an auto-polymerizing acrylic resin was applied on the occlusal surfaces and inserted in the patient’s mouth. Then, the functionally generated path (FGP) of occluding surfaces of opposing arches was traced on the resin surface. When the resin was hardened, the modified interim prosthesis was removed and digitized using an intraoral scanner. The scan image was used in designing the occlusal morphology of definitive prosthesis by modifying the design of the interim prosthesis using the dual scan method. Lastly, a monolithic zirconia prosthesis was fabricated by milling a zirconia block. The definitive prosthesis was delivered reflecting the patient’s occlusal scheme. This case report shows that the FGP technique with the dual scan method can help in fabricating fixed prosthesis with harmonious occlusion in a tardive dyskinesia patient.

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