Superimposition of intraoral scans of an edentulous arch with implants and implant-supported provisional restoration, implementing a novel implant prosthetic scan body

Abstract

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.

Reverse scan body: A complete digital workflow for prosthesis prototype fabrication

“…The accuracy of fit of each milled ( n = 50) and 3D‐printed ( n = 50) prototype prosthesis was then tested on the master cast (Figure 5). Two experienced clinicians (PP, AB) tested the accuracy of fit of each prototype prosthesis on the master cast using the screw‐resistance test, visual inspection, and periapical radiographs 12‐15 . For each prototype to be tested, the prosthesis prototype was placed on the master cast, anthe prosthetic screws were placed and hand‐tightened in a sequence from one terminal abutment to the other starting from the maxillary right side to the maxillary left side (maxillary right molar, maxillary right canine, maxillary left canine, and last maxillary left molar) 7,10,13‐15 .…”

“…Two experienced clinicians (PP, AB) tested the accuracy of fit of each prototype prosthesis on the master cast using the screw-resistance test, visual inspection, and periapical radiographs. [12][13][14][15] For each prototype to be tested, the prosthesis prototype was placed on the master cast, anthe prosthetic screws were placed and hand-tightened in a sequence from one terminal abutment to the other starting from the maxillary right side to the maxillary left side (maxillary right molar, maxillary right canine, maxillary left canine, and last maxillary left molar). 7,10,[13][14][15] During the tightening of each prosthetic screw, if complete seating required more than half a turn of the screwdriver after initial resistance was felt, it was deemed a misfit (Figure 6).…”

“…Full-arch digital implant scanning with intraoral scanners (IOS) for the fabrication of prosthesis prototypes and definitive zirconia implant fixed complete dental prostheses (IFCDPs) is gaining popularity. [1][2][3][4][5][6][7][8][9][10][11][12] Full-arch digital implant scans for completely edentulous patients are techniquesensitive procedures mainly due to the absence of anatomical landmarks such as teeth, making the superimposition of scans with scan bodies and interim prostheses challenging. [1][2][3][4][5][6] The double digital scanning technique with the use of fiducial markers has been introduced for complete digital workflow for prosthesis prototype fabrication.…”

“…The double digital scanning technique with the use of fiducial markers has been introduced for complete digital workflow for prosthesis prototype fabrication 2 . Fiducial markers are used to aid in data acquisition during edentulous jaw intraoral scanning and to assist in the merging of multiple digital scans 7‐12 . However, even with the use of fiducial markers, intraoral scanning especially in the edentulous mandible remains challenging.…”

“…2 Fiducial markers are used to aid in data acquisition during edentulous jaw intrao-ral scanning and to assist in the merging of multiple digital scans. [7][8][9][10][11][12] However, even with the use of fiducial markers, intraoral scanning especially in the edentulous mandible remains challenging. The presence of saliva, sensor fogging, and lack of keratinized mucosa coupled with advanced mandibular resorption may affect negatively data acquisition with intraoral scanning.…”