Anterior guidance is of crucial importance for maintaining the health of oral and maxillofacial system. Inadequate anterior guidance has been demonstrated to result in tooth wear, mechanical complications of restorations, and temporomandibular joint disorders. At present, no consensus exists on quantitative standards for ideal anterior guidance due to considerable inter-individual variability. Nevertheless, it can be considered that ideal anterior guidance must adhere to five qualitative standards: (1) Anterior guidance must not disturb mandibular movement. (2) The inclination of incisal guidance must be steeper than that of the condylar guidance. (3) Symmetrical guidance of the anterior teeth and disocclusion of the posterior teeth during protrusion. (4) Lateral movement facilitated with canine protection or group function, with no interference on the balanced side. (5) Positive subjective experiences of patients in terms of aesthetics, pronunciation, and mastication. It is incumbent upon clinical dentists to prioritize the rationality of the anterior guide when designing and implementing anterior aesthetic restorations. In the event of a rational anterior guidance, there is a strong recommendation for digital occlusal function design and fully anatomical all-ceramic restorations. In cases where the anterior guidance is either irrational or ineffective, reconstruction is strongly advised during the aesthetic restoration.

The dentition in the aesthetic area is crucial for functions such as chewing, pronunciation, and aesthetics. Traditional aesthetic restoration techniques are based on diagnostic wax-up to create diagnostic mock-ups or temporary restorations to present therapeutic outcomes, which requires the cooperation of dentists, technicians, and patients, and takes a considerable amount of time. With the development of digital technology, the "virtual patient" technology has emerged. With the aid of the static virtual patient technique, possible problems, such as discomfort during impression in traditional techniques, damage to diagnostic wax-up during transportation, and repeated modifications and visits when patients are dissatisfied with the design, have been avoided, and patient satisfaction is effectively improved. By attaching mandibular movement trajectory data and facial dynamic data, the morphology and position of the incisor edge and lingual and labial surfaces of the anterior teeth are more suitable for the patients. This reduces the time and difficulty of occlusal adjustment in the clinic, lowers the risks of occlusal interference, occlusal trauma, porcelain breaking, or restoration detachment, and improves the aesthetic and occlusal function of the restorations. Nowadays, the virtual patient technology requires a large number of devices with high costs, inconsistent accuracy, and file formats, high technical sensitivity, and sophisticated registration processes, etc. Its application is still subject to certain limitations. If the collection of data required for virtual patients can be completed on a single device, and the function of automatically registering multi-source data can be accomplished with artificial intelligence technology in the future, it will greatly popularize the technology for virtual patients.

To evaluate the clinical application value of T-Scan Ⅲ system in the evaluation of occlusal reconstruction and restoration effect of fixed dentures.

A retrospective analysis was conducted on the T-Scan Ⅲ dynamic bite data of 22 patients who were clinically diagnosed and completed fixed denture bite reconstruction in the Department of Prosthodontics, the Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University from January 2022 to December 2023. The detection time points included: Before bite reconstruction (T0), immediately after restoration (T1), and 1 year after restoration (T2). The analysis parameters included: Asymmetry index of the occlusal force (AOF), Central occlusal force (COF) position, Occlusion Time (OT) and Disocclusion Time (DT), percentage of left and right occlusion force distribution, etc. SPSS 18.0 software was used for statistical analysis of the data, and t-test or McNemar-test was used to compare the differences before and after treatment.

The AOF of patients undergoing fixed denture occlusal reconstruction decreased significantly from T0 stage (32 ± 10) % to T2 stage (10 ± 6) % (t = -5.820, P<0.001), and the balance of bite force distribution was significantly improved. The proportion of COF located outside the functional center decreased from 77.3% (17/22) in T0 phase to 13.6% (3/22) in T1/T2 phase (χ²=12.071, P<0.001), and the distance from the midline shortened from (9.80 ± 3.89) mm to (3.60 ± 2.04) mm (t = -5.391, P<0.001). OT shortened from (0.97 ± 0.14) s to (0.33 ± 0.10) s (t = -6.343, P<0.001) ; The DT of protrusive movement decreased from (0.81 ± 0.11) s to (0.19 ± 0.05) s (t = -6.445, P<0.001). The excursive movement DT showed synchronous improvement (t_{left side}=-6.340, P_{left side}<0.001; t_{right side}=-6.395, P_{right side}<0.001) .

T-Scan Ⅲ can be used for quantitative analysis of bite reconstruction effects, providing reliable basis for clinical evaluation and adjustment of treatment plans.

Severe dental wear is a chronic disease characterized by progressive loss of hard dental tissues, often leading to reduced occlusal vertical dimension, disordered jaw relationships, and decreased masticatory function, seriously affecting patients' stomatognathic system function and quality of life. Occlusal reconstruction for this condition faces challenges including difficulty in determining jaw position, limited restorative space, and multidisciplinary coordination requirements. This article reports the sequential treatment of a patient with occlusal disorder accompanied by severe dental wear and anterior open bite, summarizing the treatment experience for such complex cases. A 56-year-old male patient presented with severe bilateral posterior tooth wear and anterior open bite, with a 20-year history of bruxism, and refused to wear an occlusal splint. A selective restoration strategy was formulated based on the degree of wear and functional requirements, using sequential treatment methods for occlusal reconstruction. The treatment was divided into 4 phases: (1) Acute symptom control and basic prevention phase, using digitally-guided selective occlusal adjustment to stabilize occlusal relationships; (2) Disease control phase, completing periodontal basic treatment and root canal treatment; (3) Functional and aesthetic reconstruction phase, completing implant restoration and all-ceramic crown and veneer restoration for worn teeth; (4) Maintenance phase, fabricating night guards and conducting regular follow-ups. After treatment, the patient's anterior open bite was completely corrected, with significant improvement in both aesthetics and function. At 12-month follow-up, the patient's stomatognathic system functions including occlusion, joints, and phonetics were well-coordinated. Prosthetic restorations remained intact. Oral Health Impact Profile-14 (OHIP-14) scores were improved from 41 to 12 points. Masticatory efficiency increased from 1.89 to 2.68. The patient was satisfied with the treatment outcomes. This case provides a feasible treatment approach for patients with severe wear who refuse splint therapy.

Implant restoration in the aesthetic zone involves substantial clinical risks and challenges. With the application and development of digital technology, shifting the focus of treatment to the initial design phase to guide subsequent surgery, to reduce operational difficulty, to enhance the predictability of treatment outcomes, and ultimately to achieve precise restoration of aesthetics and function remains an ongoing exploration for clinicians. The organic integration of various digital tools has gradually made these objectives a reality. Digital design enables the integration of intraoral and facial scan images with electronic facebow and cone-beam computed tomography (CBCT) data, facilitating three-dimensional reconstruction and virtual patient modeling for restorative outcome prediction. The "start with the end" philosophy ensures precision throughout implant and prosthetic procedures. This case report demonstrates the application of digital workflows to restore smile aesthetics and function in a patient presenting with severe anterior bone defects and multiple missing teeth. A combination of digital technologies guided treatment planning, aesthetic simulation, and surgical-prosthetic execution, culminating in successful implant and crown rehabilitation. Six-month follow-up revealed optimal restorative outcomes, with significant improvements in anterior esthetics and occlusal function.

This case report described the functional and aesthetic rehabilitation of anterior teeth using digital techniques. The patient complained of aesthetic dissatisfaction and occlusal discomfort following previous porcelain-fused-to-metal union crowns. Comprehensive functional and aesthetic evaluations were conducted utilizing digital smile design (DSD), electronic facebow, and intraoral scanning, so as to analyze occlusal relationships and tooth aesthetic proportions, allowing for the development of an individualized treatment plan. DSD was used for aesthetic preview and effective patient communication, clarifying expectations and potential risks. The electronic facebow and virtual articulator facilitated the adjustment of the incisal guidance of the provisional crown, alleviating mandibular movement limitations and masseter fatigue. CAD/CAM and intraoral scanning enabled precise replication of provisional restorations and ensured optimal harmony in contour, shade, and function for the final prostheses. After two years of follow-up, the patient reported satisfaction with both esthetic outcome and occlusal comfort. This case highlighted the critical role of digital techniques in integrating aesthetics and function, enhancing predictability and ensuring long-term stability in complex anterior restorations.

This article reports a case of anterior aesthetic restoration using a fully digital workflow. By integrating digital intraoral scans, facial scanning data, and mandibular movement trajectory information, a four-dimensional virtual dental patient was developed using advanced digital design software. The four-dimensional virtual dental patient model facilitated both intraoral and facial aesthetic simulations, as well as virtual occlusal adjustments, significantly reducing the need for occlusal modifications in the clinical setting. This approach ensured the mechanical performance and aesthetic outcome of the restoration, achieving a harmonious balance between function and aesthetics.

Prosthodontics encompasses the restoration of both function and aesthetics, involving clinical workflows, customized prosthesis fabrication, and interdisciplinary information exchange and communication among clinicians, technicians, and patients. Inadequate clinician-patient communication is the primary contributor to conflicts within this field. The application of digital technologies facilitates enhanced communication and improved clinician-patient relationships. This article explores the utilization of digital technologies in clinician-patient communication for prosthodontics, such as intraoral scanning, virtual design, and digital platforms. These technologies optimize the pre-treatment examination process, precisely capture patient needs and aesthetic preferences, visualize potential treatment outcomes, enhance procedural transparency, and enable early risk identification. These technological innovations shift prosthodontics from experience-based to data-driven approaches, thereby enhancing patient satisfaction, optimizing treatment outcomes, and fostering the harmonious development of clinician-patient relationships.

Zirconia ceramics are widely used in the field of dentistry. However, to achieve optimal esthetics, zirconia is typically layered with translucent veneering porcelain due to its opaque appearance. Owing to the weak bond between zirconia ceramic core and veneer, chipping and delamination of the veneering ceramic are the most frequent reasons for failure of zirconia-based restorations. Therefore, to promote the long-term success of zirconia restorations, the bond strength between the core and veneer must be strengthened. This review analyzes the causes of the high chipping rate in zirconia-based restorations and summarizes surface treatment techniques including air abrasion, laser etching, hot acid etching, liner, plasma treatment, etc.