Vailati Francesca, Belser Urs Christoph
Department of Fixed Prosthodontics and Occlusion, School of Dental Medicine, University of Geneva, Switzerland.
Eur J Esthet Dent. 2008 Spring;3(1):30-44.
Traditionally, a full-mouth rehabilitation based on full-crown coverage has been the recommended treatment for patients affected by severe dental erosion. Nowadays, thanks to improved adhesive techniques, the indications for crowns have decreased and a more conservative approach may be proposed. Even though adhesive treatments simplify both the clinical and laboratory procedures, restoring such patients still remains a challenge due to the great amount of tooth destruction. To facilitate the clinician's task during the planning and execution of a full-mouth adhesive rehabilitation, an innovative concept has been developed: the three-step technique. Three laboratory steps are alternated with three clinical steps, allowing the clinician and the laboratory technician to constantly interact to achieve the most predictable esthetic and functional outcome. During the first step, an esthetic evaluation is performed to establish the position of the plane of occlusion. In the second step, the patient's posterior quadrants are restored at an increased vertical dimension. Finally, the third step reestablishes the anterior guidance. Using the three-step technique, the clinician can transform a full-mouth rehabilitation into a rehabilitation for individual quadrants. This article illustrates only the first step in detail, explaining all the clinical parameters that should be analyzed before initiating treatment.
传统上，对于患有严重牙侵蚀的患者，基于全冠覆盖的全口修复一直是推荐的治疗方法。如今，由于粘接技术的改进，冠修复的适应症有所减少，可以采用更保守的方法。尽管粘接治疗简化了临床和实验室操作，但由于牙齿破坏严重，修复此类患者仍然是一项挑战。为了在全口粘接修复的计划和实施过程中方便临床医生的工作，已开发出一种创新理念：三步技术。三个实验室步骤与三个临床步骤交替进行，使临床医生和实验室技术人员能够不断互动，以实现最可预测的美学和功能效果。在第一步中，进行美学评估以确定咬合平面的位置。在第二步中，以增加的垂直维度恢复患者的后牙象限。最后，第三步重新建立前牙引导。使用三步技术，临床医生可以将全口修复转变为单个象限的修复。本文仅详细阐述第一步，解释在开始治疗前应分析的所有临床参数。
