Graduate student, Department of Prosthodontics, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, PR China; Resident, Shanghai Jingan Dental Clinic, Shanghai, PR China.
Lecturer, Department of Prosthodontics, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, PR China.
J Prosthet Dent. 2019 Aug;122(2):95-103. doi: 10.1016/j.prosdent.2018.10.028. Epub 2019 Apr 9.
A 20-year-old woman presented with an unesthetic appearance and severe wear of the anterior teeth. Definitive expected treatment was designed by multidisciplinary combination therapy. Meanwhile, gene sequencing was used diagnostically, and digital smile design (DSD) was used to design the esthetics of the anterior teeth. The 3-month follow-up showed an acceptable outcome. The whole-exon sequencing and direct sequencing of polymerized chain reaction products of dentin sialophosphoprotein were performed, but further sequencing was needed in the repeat region of dentin sialophosphoprotein exon 5 (the data were not shown). DSD assisted and improved the esthetic design of the definitive restoration, communication with the patient, and predictability of the treatment. This treatment demonstrates that the diagnosis and differential diagnosis of patients with dentinogenesis imperfecta (DGI)-II are essential and effective for implementing the definitive treatment plan. Gene screening can be used as an auxiliary method of diagnosing DGI-II. In terms of esthetic design, DSD played an important role in ensuring a satisfactory result. Moreover, a multidisciplinary treatment protocol focusing on prosthodontics, which is different from the traditional treatment of DGI-II and consists solely of prosthodontic rehabilitation, proved highly effective in the esthetic restoration of a patient with DGI-II.
一位 20 岁的女性前来就诊，她的前牙不美观且严重磨损。通过多学科联合治疗设计了明确的预期治疗方案。同时，采用基因测序进行诊断，使用数字化微笑设计（DSD）设计前牙的美观。3 个月的随访显示出可接受的结果。进行了牙本质涎磷蛋白的全外显子测序和聚合酶链反应产物的直接测序，但牙本质涎磷蛋白外显子 5 的重复区域需要进一步测序（数据未显示）。DSD 辅助并改善了最终修复的美学设计、与患者的沟通以及治疗的可预测性。这种治疗表明，牙本质生成不全症（DGI）-II 患者的诊断和鉴别诊断对于实施明确的治疗计划至关重要且有效。基因筛查可作为诊断 DGI-II 的辅助方法。在美学设计方面，DSD 对于确保满意的效果起着重要作用。此外，多学科治疗方案侧重于口腔修复学，与传统的 DGI-II 治疗方法不同，仅包括口腔修复学康复，在 DGI-II 患者的美学修复中证明非常有效。
