A technique for digital alignment of cross-articulated casts in a computer-aided design software program for complete-mouth rehabilitation

With the advent of computer-aided design and computer-aided manufacturing (CAD-CAM), dental restorations are no longer fabricated in an entirely analog fashion. Successful execution of complete-mouth rehabilitations requires articulation of definitive maxillary and mandibular casts with tooth preparations, as well as cross-articulation with the patient’s interim restorations. These cross-articulated records serve as a guide for the dental laboratory technician in fabricating the definitive restorations. In the CAD-CAM workflow, cross-articulation and overlaying of a patient’s interim casts over the definitive casts of tooth preparations poses some challenges because of loss of common anatomic data points such as incisive papilla, rugae, and the palate. This article describes a straightforward technique to overcome this common challenge, where a dental laboratory technician can predictably overlay the digitized interim casts to allow for cross-articulation and proceed with designing and fabricating the definitive restorations.