The splinted technique generated more accurate master casts than the non-splinted technique for one-piece IFCDPs in edentulous jaws and the null hypothesis was rejected. These clinical implications demonstrate improved accuracy of splinted impression techniques compared with the non-splinted technique. For the external connection, the implant system used in this study, a 3-D misfit ranging from 59 to 72 μm, may be considered the maximum discrepancy resulting in an acceptable clinical fit with one-piece IFCDPs.
CAD/CAM zirconia IFCDPs are viable prosthetic treatment after 2-4 years in function, but not without complications. The porcelain chipping/fracture was the most frequent technical complication, with a 31.25% chipping rate at the prosthesis level. Despite the technical complications, increased patient satisfaction was noted.
Surgical and prosthodontic implant complications are often an inadvertent sequelae of improper diagnosis, planning, and placement. These complications pose a significant challenge in implant dentistry. Presented in this article is a technique using a highly advanced software program along with a rapid prototyping technology called stereolithography. It permits graphic and complex 3D implant simulation and the fabrication of computer-generated surgical templates. These templates seat directly on the bone and are preprogrammed with the individual depth, angulation, and mesio-distal and bucco-lingual positioning of individual implants as planned during the 3D computer simulation.
Eight implants were placed in the posterior part of the mandible using computer-generated stereolithographic templates. Preoperative implant simulation was done on a 3D computer model created by reformatted computerized tomography data. The surgeon and the prosthodontist positioned the simulated implants in the most favorable position addressing all concerns with regard to anatomy, biomechanics, and esthetics. The length and diameter of each implant along with the angulation/collar of abutments required for a screw-retained prosthesis were determined. Stereolithographic templates were then fabricated by incorporating the precise spatial position of the implants within the bone as previously planned during the computer simulation. The templates were fabricated to seat directly on the bone and were stable. The first template was used to complete osteotomies with a 2-mm twist drill followed by the second template for the 3-mm drill. Implants were placed and allowed to integrate for 4 months. After second-stage surgery, the definitive abutments were torqued into place followed by insertion of the definitive screw-retained prostheses. Dimensions of all implants and abutments were the same as planned during the computer simulation.
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