Purpose To assess the accuracy of fit of prosthesis prototypes fabricated via a complete digital workflow protocol with a reverse scan body skipping intraoral scanning for implant data acquisition. Materials and methods A maxillary stone cast with four multiunit abutment implant analogs (Screw‐Retained Abutments, Institut Straumann AG, Basel, Switzerland) with adequate anteroposterior spread simulated a common clinical patient situation. This stone cast served as the master cast and an interim screw‐retained prosthesis was fabricated on it. Novel reverse scan bodies were connected to the interim prosthesis, and extraoral scanning was performed with a white light intraoral scanner. The produced standard tessellation language (STL) files were then imported to computer‐assisted design software and after the digital design, the STL file was exported to a computer‐assisted machining milling machine and a three‐dimensional (3D) printer to produce a total of 50 milled and 50 printed fixed complete denture prototypes, respectively. Two clinicians assessed the accuracy of fit of each digitally fabricated prosthesis prototype on the master cast, utilizing the screw‐resistance test and radiographic evaluation. Out of the 100 prototypes, 94% (94/100) were fitting accurately. Fisher's exact test was used to test the difference among the groups. The test revealed statistically significant results (p = 0.027). Results Out of the 50 digitally fabricated milled prosthesis prototypes, 50 (100%) presented with accurate fit under in vitro assessment. Out of the 50 digitally fabricated 3D printed prototypes, 44 (88%) presented with accurate fit under in vitro assessment. Conclusions Accurately fitting digitally fabricated prosthesis prototypes can be milled after extraoral scanning with reverse scan bodies without intraoral implant data acquisition.
To describe a technique utilizing a novel prosthetic scan body, that assists the accurate merging of multiple scans (intra-and extraoral) of the interim prosthesis and edentulous arch with dental implants, during rehabilitation with a fixed implant-supported prosthesis. Methods: Intraoral scanning (Trios 3, 3Shape) of an interim implant-supported prosthesis was performed, subsequently followed by another scan, using five scan bodies, placed onto the implant abutments (SRA, Bone level, Straumann AG). Successively, the newly designed prosthetic scan bodies were attached to the abutment copings of the interim prosthesis, for extraoral scanning. Utilizing an implant library designed for the prosthetic scan body, the three scans were merged, providing all the necessary information for the digital design and fabrication of the fixed implant-supported prosthesis. Conclusion:The described clinical technique enabled effective and accurate superimposition of intra-and extraoral scans of the implant prosthesis. Superimposed data, including that of the position of dental implants and anatomy of soft tissue, provided essential information for the fabrication of a definitive implant-supported prosthesis. The novel prosthetic scan bodies attached to the implant prosthesis, assisted in merging intra-and extraoral scans, thus facilitating the rehabilitation of maxillary and/or mandibular edentulous dental arches. Further research is required to assess the accuracy of the proposed technique.
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