CAD–CAM-Fabricated Provisional Restoration for Bite Registration in Combined Fixed and Removable Prosthodontic Rehabilitation

Background: Elderly patients often experience difficulty adapting to occlusal reconstruction. Therefore, accurate bite registration is mandatory to ensure precise transfer of the established maxillomandibular relationship to the definitive prosthesis. However, conventional bite registration methods may compromise reproducibility because of deformation of registration materials and instability of mucosa-supported record bases. Methods: A 65-year-old woman with the primary complaints of unstable occlusion and difficulty in mastication underwent occlusal reconstruction. After occlusal stabilization using provisional crowns, bridges, and removable partial dentures, definitive impressions were made with and without the provisional restorations. The casts were scanned, and the digital datasets were superimposed to reproduce the established occlusal morphology of the provisional restorations. This occlusal morphology was used to design a tooth-supported computer-aided design–computer-aided manufacturing (CAD–CAM)-fabricated milled provisional restoration. Following intraoral verification of occlusal stability, the milled provisional restoration served as a mounting guide for the working casts on an articulator. Definitive crowns, bridges, and removable partial dentures were then fabricated. Results: Following comprehensive prosthodontic rehabilitation with definitive prostheses, occlusal stability and masticatory function improved, and the patient was satisfied with the functional outcomes of treatment. Conclusions: A tooth-supported CAD–CAM-fabricated milled provisional restoration used as a bite registration device enables potentially more consistent transfer of the maxillomandibular relationship while avoiding mucosal displacement and material deformation. This technique, which integrates digital and conventional workflows, may provide a new option for addressing adaptation challenges in occlusal reconstruction.