Digital Device in Postextraction Implantology: A Clinical Case Presentation

Abstract

Aim. The aim of this work is to describe a case of immediate implant placement after extraction of the upper right first premolar, with the use of CAD/CAM technology, which allows an early digital impression of the implant site with an intraoral scanner (MHT 3D Progress, Verona, Italy). Case Report. A 46-year-old female was referred with a disorder caused by continuous debonding of the prosthetic crown on the upper right first premolar. Clinically, there were no signs, and the evaluation of the periapical radiograph showed a fracture of the root, with a mesial well-defined lesion of the hard tissue of the upper right first premolar, as the radiolucent area affected the root surface of the tooth. It was decided, in accordance with the patient, that the tooth would be extracted and the implant (Primer, Edierre implant system, Genoa, Italy) with diameter of 4.2 mm and length of 13 mm would be inserted. After the insertion of the implant, it was screwed to the scan abutment, and a scan was taken using an intraoral scanner (MHT 3D Progress, Verona, Italy). The scanned images were processed with CAD/CAM software (Exocad DentalCAD, Darmstadt, Germany) and the temporary crown was digitally drawn (Dental Knowledge, Milan, Italy) and then sent to the milling machine for production with a composite monoblock. After 4 months, when the implant was osteointegrated, it was not necessary to take another dental impression, and the definitive crown could be screwed in. Conclusion. The CAD/CAM technology is especially helpful in postextraction implant for aesthetic rehabilitation, as it is possible to immediately fix a provisional crown with an anatomic shape that allows an optimal healing process of the tissues. Moreover, the removal of healing abutments, and the use of impression copings, impression materials, and dental stone became unnecessary, enabling the reduction of the chair time, component cost, and patient's discomfort. However, it is still necessary for scientific research to continue to carry out studies on this procedure, in order to improve the accuracy, the reliability, and the reproducibility of the results.

Digital versus Traditional Workflow for Immediate Loading in Single-Implant Restoration: A Randomized Clinical Trial

“…The use of the digital method decreases session time since prostheses can be fabricated more rapidly than with the conventional impression technique [ 21 ], thereby increasing patient’s acceptance of the impression procedure [ 22 ].…”

“…However, digital procedures also present some disadvantages [ 20 , 21 ], as for instance the necessity of establishing a learning curve before obtaining satisfactory results. A further disadvantage is represented by the high cost of the devices.…”

“…The new available technologies, such as the intraoral scanners and the CAD-CAM technologies, together with the availability of prosthetic materials render the immediate-loading protocol [ 21 ] possible, with a remarkable decrease in procedure times, improved patient satisfaction and suitable esthetic results [ 27 , 28 ].…”

In Vitro Assessment of the Cell Metabolic Activity, Cytotoxicity, Cell Attachment, and Inflammatory Reaction of Human Oral Fibroblasts on Polyetheretherketone (PEEK) Implant–Abutment

“…Polyetheretherketone (PEEK) has recently attracted considerable attention due to its esthetic properties and has been successfully introduced into the dental field [ 1 , 4 ]. PEEK is very useful in digital dentistry [ 6 ] and in general when immediate loading [ 7 ] or preimplant surgery procedures [ 7 , 8 ] are requested; moreover, PEEK displays good shock absorption and fatigue and abrasion resistance and is highly stable in the oral cavity without undergoing physicochemical changes [ 2 , 4 , 9 ]. Additionally, PEEK overcomes the problems caused by the brittle properties of ceramic materials and artificial techniques, such as staining, which can adjust the final color, thereby conquering the unpleasing appearance of alloy materials [ 10 ].…”

Comparison of digital and silicone impressions for single-tooth implants and two- and three-unit implants for a free-end edentulous saddle

“…The use of IOS has facilitated the use of digital workflows for the fabrication of implant-supported prostheses not only for single missing teeth, but also for multiple missing teeth [ 4 , 5 ]. The benefits of using IOS include reduced patient discomfort, shorter chair time, shorter prosthesis fabrication time, and the ability to store patients’ biometric information as data [ 6 , 7 ]. However, only a few clinical studies have reported on the utility of IOS for implant-supported prosthetic treatment.…”