A combined digital-conventional workflow to fabricate a removable partial denture for a patient with a severe gag reflex Ronan B O'Leary Anne L Gunderman Dental Update 2024 47:9, 707-709.
Authors
Ronan BO'Leary
BA, BDentSc, Dip PCD, MFD(RCSI), MAcadMEd, Senior House Officer in Restorative Dentistry, Division of Restorative Dentistry and Periodontology, Dublin Dental University Hospital, Lincoln Place, Dublin 2 D02 F859
BS, DDS, MS, Diplomate of the American Board of Prosthodontics, Senior Lecturer Graduate Prosthodontics, Trinity College Dublin/Dublin Dental University Hospital; Private Practice Limited to Prosthodontics, Fitzwilliam Square, Dublin 2, D02 CY65, Ireland.
Introducing a novel approach to overcoming a profound gag reflex and aversion to conventional dental impression procedures when fabricating a removable partial denture. The digital workflow is becoming increasingly popular in the discipline of fixed prosthodontics. Chairside digitization of a patient's dentition is a less invasive and more comfortable procedure in comparison to conventional dental impression techniques. The advantages can be most relevant to patients with a profound gag-reflex. Currently, certain challenges exist with full digitization in the discipline of removable prosthodontics. Combining digital and conventional workflows may serve as an alternative technique to construct removable prostheses for groups who cannot tolerate conventional methods.
CPD/Clinical Relevance: Many patient groups may not tolerate conventional dental impression techniques. This method offers a combination of existing techniques as a suitable alternative for this cohort.
Article
The digital workflow is established now as a clinically acceptable method of fabricating single unit crowns or short-span fixed partial dentures (FPDs), both on natural teeth1–6 as well as dental implants,7,8 in the discipline of fixed prosthodontics. One of the main advantages of this workflow is from the perspective of patient comfort. Direct chairside digitization of a patient's dentition is a less invasive and more comfortable procedure in comparison to conventional dental impression techniques using either irreversible hydrocolloids or elastomeric impression materials. The literature suggests that this patient comfort factor is most relevant in patients who experience a profound gag reflex.9
However, currently, direct chairside digitization is considered to be less predictable for the fabrication of cross-arch frameworks,10–13 such as those that might be fabricated in the discipline of removable prosthodontics. This is because of the effect of error accumulation that occurs during the stitching of multiple three-dimensional (3D) images over a broad surface area during the chairside digital impression procedure. The literature suggests that such error accumulation can reach clinically relevant levels of inaccuracy in full-arch digital dental impressions.10–14
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