Digital workflow for TMD diagnostics and bite alteration: description of a case treated using Sicat Function

A patient with arthrogenic temporomandibular dysfunction (TMD) complaints presented. In addition to a clinical diagnosis, an instrumental one with Sicat Function (Sicat) was performed. For this purpose, movements of the mandibular function were recorded with an ultrasonic-based measuring system (JMT+) and correlated with cone beam computed tomography (CBCT) image data. A reference tray (FusionBite) ensured spatial agreement. In addition, full-arch scans taken with the Cerec Omnicam intraoral scanner (Dentsply Sirona) were matched to the CBCT data. From the movement data, a biomechanically optimized joint position was determined, for which an occlusal splint was milled. Subsequently, the functional result achieved was retained with computer-aided design/computer-aided manufacturing (CAD/CAM) temporary restorations and tabletops and was monitored with Sicat Function until delivery of the final rehabilitation. To this end, the movements were tracked with the JMT+ after each treatment step. The reference tray was successively adapted and augmented so that the original jaw relation in the FusionBite could be maintained, which guaranteed comparability with the initial situation without the need for an additional CBCT image. Sicat Function has proven to be an excellent system supporting a digital workflow in situations where controlled bite-position changes are indicated in patients with arthrogenic TMD complaints. Keywords: instrumental digital functional diagnostics, Sicat Function, CAD/CAM, Cerec, digital workflow, TMD diagnostics, digitally guided bite-position change