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Open in a separate window Modified from [ 5 , 7 ]. DI: Dentinogenesis Imperfecta. DI is an autosomal dominant form of mesodermal dysplasia that affects both primary and permanent dentition. DI associated with OI generally affects primary dentition more severely than permanent dentition.
Although the enamel appears structurally normal, it is often dislodged, exposing soft, dysplastic dentin to the oral cavity and provoking rapid, extensive attrition [ 3 , 9 ]. Histologically, exposed dentin is generally characterized by irregular tubules. Radiographically, teeth affected by DI show cervical constriction, bulbous crowns, short roots, short pulp chambers, and obliterated canals [ 10 ]. Adult patients with OI frequently exhibit class III malocclusions, anterior or posterior cross-bite, posterior open-bite, and vertical height loss [ 1 , 3 , 11 ].
Conventional casting is the most frequently used technique for manufacturing Co-Cr alloys for the fixed partial dentures. In recent years, modern computer-aided technologies for manufacturing individual prostheses have been gaining popularity in the field of dental technology [ 12 ]. Computer-aided design CAD and computer-aided manufacturing CAM technologies are used frequently in the dental field to fabricate prostheses ranging from crowns to long-span fixed partial dentures and from removable prostheses to dental implants [ 13 ].
These systems were developed to address a number of disadvantages of the traditional casting method e. DMLS is an additive metal fabrication technology that involves the use of a high-power Yb-fiber optic laser [ 15 ]. In this technology, metal powder is melted locally with a focused laser beam and fused into a solid part. DMLS technology affords highly accurate production of fixed partial dentures with fine marginal adaptation and excellent mechanical properties [ 13 , 16 ].
This paper presents the multidisciplinary dental treatment of a young patient with DI related to OI. Also, this clinical report explores the use of direct metal laser sintering technique for the fabrication of posterior Co-Cr metal-ceramic fixed partial dentures and zirconium anterior restorations for the treatment of vertical height loss with complete mouth rehabilitation. A detailed dental and medical history was obtained. The medical history indicated that the patient had been diagnosed with OI and was being treated orthopedically.
An extraskeletal clinical examination showed the patient to have moderately short stature, a femoral deformity, and a narrow shoulder breadth. An extraoral examination assessing vertical dimension of occlusion and vertical dimension at rest showed that attrition of the posterior teeth had resulted in an increase in interocclusal rest space approximately 9 mm.
The patient also complained of continuously chipping of teeth in both arches while masticating Figure 1. Intraoral examination showed that eruption of the permanent teeth was complete and that teeth 16, 26, 36, and 46 had been restored with stainless steel crowns SSC Figure 2. There was extensive destruction of enamel, which was opaque-white in color, whereas dentin was yellowish brown.
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