Prosthodontic treatment of a patient with psoriasis using digital workflow
Abstract
Introduction: Psoriasis is an inflammatory skin disease mainly caused by genetic factors and age. Several risk factors
have been identified: stress, smoking, excessive alcohol consumption, and obesity. Patients with psoriasis who were not
treated in the literature had a significantly higher incidence of certain dental pathological conditions.
Case report: The 58-year-old patient in this case report suffers from psoriasis, for which he is receiving biological therapy.
He had no other influencing factors in his medical history. In 2022, he visited the Department of Restorative Dentistry
and Endodontics of Semmelweis University to prepare his permanent prosthesis. Two prostheses made with digital workflow
were indicated for the maxilla. Both restorations were made of monolithic full-contour zirconia. For the upper right
posterior region, a 4-unit bridge was produced using CAD/CAM technology with the abutment teeth of 17 and 14. In the
anterior region, the patient had three implants (13, 11, and 21), therefore, a 5-unit screw-retained bridge restoration with
a titanium base was designed. After removing the temporary prosthesis, the abutment teeth were shoulder-prepared, and
the scanbodies were fixed into the implants, followed by the precision-situational and antagonistic scans. Before scanning,
the exact fit of the scanbodies was also checked on radiographs. The habitual bite was retained and transferred to the final
intercuspid position using the software used. The finished dentures were first checked on the 3D-printed model and then
tried in the mouth. The bridge is anchored on the implants by one screw for checking the passive fit in radiographs. Then
the bridge was fixed by all screws using 35Ncm. The patient did not report any discomfort during the short and long-term
check-ups, the prostheses functioned well, and the patient maintained good oral hygiene.
Conclusion: Nowadays, digital workflow is a predictable procedure for fixed and implant-anchored restorations. Patients
undergoing biological therapy are treated with particular care; it is always essential to consult the patient’s primary
care physician, especially when invasive procedures are involved.
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