Purpose: The aim of this study was to estimate the tendency of metal-free restoration for premolar teeth.

Methods: We counted the number of CAD/CAM resin crowns, resin jacket crowns and metal crowns to set for premolar teeth at the Nippon Dental University Hospital from April 2014 to March 2016. Complications (loss of retention, fracture, etc.) and setting procedures were evaluated regarding CAD/CAM resin crowns with questionnaires.

Results: The total number of CAD/CAM resin crowns, resin jacket crowns and metal crowns were 474, 196 and 818, respectively. The number of CAD/CAM resin crowns increased gradually and accounted for 51.3% of crown restorations for premolar teeth in March 2016. After 2 years, the complication rate was 5.7% and only 37.8% of cases were with sandblasting.

Conclusions: The rate of CAD/CAM resin crowns increased and it was suggested that CAD/CAM resin crowns are used as crown restorations for premolars. However, some early complications occurred, and the results suggested that indications and adhesive procedures should be taken into consideration.

Patient: A 30-year-old female visited our hospital with chief complaints of chewing difficulty and esthetic problem. She was not satisfied with a removable partial denture for a defect caused by congenital partial anodontia, and selected oral implant therapy. Deciduous teeth with a poor prognosis were extracted, and the implant body was installed with bone augmentation because of limited bucco-lingual bone width. After the establishment of anterior guidance with provisional restorations, all-ceramic crowns of the implant lever were set as the final superstructures.

Discussion: The width of the jaw bone might be caused by anodontia. As the mucosa over the residual ridge was thin, veneer grafting was selected as a hard tissue augmentation procedure rather than the GBR to avoid fenestration of oral mucosa.

Conclusion: Oral implant treatment with bone augmentation was effective for this patient with partial anodontia and prolonged retention of deciduous teeth.

Patient: The patient was a 66-year-old man, with masticatory disturbance on the left side due to the loss of upper left molars and a root fracture of the second premolar. To improve the occlusal support, three dental implants were placed after extraction of the premolar. To obtain proper lateral guidance for this patient, interim prostheses were applied on implants for about 3 months. Finally, the final prosthesis with the occlusal form transferred from the interim prostheses was applied.

Discussion: In this case without anterior guidance, it was considered that occlusal support remained stable in the maintenance period by implant prostheses with the characteristic occlusal form transferred from the interim prostheses.

Conclusion: For unilateral maxillary free-end missing without anterior guidance, occlusal support was improved by implant prostheses with the characteristic occlusal form transferred from the interim prostheses.

Patient: A 69-year-old female presented with a chief complaint of right habitual temporomandibular joint dislocation and dysmasesis caused by malocclusion. An occlusal splint was applied to obtain appropriate occlusal contact, and masticatory exercises for the right side of the mouth were started to ameliorate the left condylar movement limitations exhibited by the patient. After confirming that the patient’s joint dislocation and dysmasesis had improved, a definitive prosthesis was installed in the stabilized mandibular position.

Discussion: In cases in which temporomandibular joint dislocation is suspected to have been caused by limited contralateral condylar movement, treatment to overcome such limitations might be effective for correcting the dislocation.

Conclusions: The combined use of occlusal treatment and masticatory exercises is an effective treatment option for habitual temporomandibular joint dislocation combined with dysmasesis.