A complete digital approach for facially generated full arch diagnostic wax up, guided surgery, and implant‐supported interim prosthesis by integrating 3D facial scanning, intraoral scan and CBCT

Abstract

Continuous innovation in digital dental technology offers new prospects for creating a complete virtual environment. The technique described adds a facial approach to the conventional digital workflow by incorporating 3D face scans to cone beam computed tomography and intraoral scans. Using this workflow, clinicians can obtain a complete virtual patient for facially generated diagnostic wax up and plan and implement a predictable implant placement and interim prosthesis. This technique provides a full digital workflow for restoratively‐driven computer‐aided implant planning, guided surgery, and 3D printing of an interim complete‐arch fixed implant‐supported prosthesis.

Digital Diagnostic Wax-up as a Part of Esthetic Dental Treatment in Front Area: a case report

“…The DDW could be improved by integrating a facial scan of soft tissues (EOS-extra oral scan) with facial skeleton (CBCTcone beam computed tomography) and dentition (IOS-intraoral scans) in statics. This approach helps the dental team to make the DDW, implant placement and future prosthesis match perfectly the patient's facial anatomy (8). The future expectations are about improvement the virtual patient in 4D real time motion (33,34).…”

“…More symmetrical teeth but with bigger axial tooth contour alterations are achieved in DDW (4,5,6). Since the digital technologies are widely introduced in Dental medicine, a DDW is used in treatment planning (7,8,9,10). It is a 3D representation of the final result as far as esthetics (shape, size, color, position, and outline), occlusion and function, marginal adaptation are concerned and it is overlaid onto a 3D digital pre-op model.…”

A New Full Digital Workflow for Fixed Prosthetic Rehabilitation of Full-Arch Edentulism Using the All-on-4 Concept

“…This development Medicina 2024, 60, 720 2 of 12 has been challenging over the years given the potential issues in the acquisition of data when using intra-oral scanners and the registration and superimposition of data in the absence of natural teeth or other anatomical references [12]. These potential issues have deserved some attention from the scientific/clinical community with the improvement in the workflow by introducing stackable guides that allow the connection of surgical guides and an interim poly(methylmethacrylate) (PMMA)-fixed prosthesis following CAD-CAM digital design and 3D printing [13][14][15][16][17][18]. Nevertheless, several limitations arise from this workflow, concerning angular deviation differences up to almost 10 degrees between planning and post-operative implant positioning [14,17]; the stability of markers and patient comfort when using the patient's face for anchoring [15]; or an increased treatment cost and CAD knowledge [18].…”

“…These potential issues have deserved some attention from the scientific/clinical community with the improvement in the workflow by introducing stackable guides that allow the connection of surgical guides and an interim poly(methylmethacrylate) (PMMA)-fixed prosthesis following CAD-CAM digital design and 3D printing [13][14][15][16][17][18]. Nevertheless, several limitations arise from this workflow, concerning angular deviation differences up to almost 10 degrees between planning and post-operative implant positioning [14,17]; the stability of markers and patient comfort when using the patient's face for anchoring [15]; or an increased treatment cost and CAD knowledge [18]. Fully digital workflows offer potential decreased rehabilitation times and increased patient satisfaction given their less invasive nature [16,19], with a highlight on the significant percentage of patients (91%) preferring flapless implant placement [19].…”

A Completely Digital Workflow of an Interim Complete Arch Fixed Implant Prosthesis Using a Novel High-Performance 3D Printed Polymer

“…Since the introduction of osseointegration to North America over 40 years ago, there have been continual permutations in surface modification, applications, diagnostic and treatment workflows, design, materials, as well as manufacturing [1][2][3][4][5]. Despite this progress, the discovery of a high-performance prosthetic material that is economical and efficiently manufactured has eluded the field for the implant restoration of the completely edentulous patient.…”