A new digital denture procedure: a first practitioners appraisal

Abstract

BackgroundHistorically, the complete removable denture is the last prosthetic procedure to switch to digital techniques whose advantages are mainly observed in the laboratory stages; however, it is not possible to measure the depressibility of the oral mucosa using optical cameras, thus conventional impression techniques are still necessary. This article describes the clinical and laboratory procedure and practitioners appraisal of the first fifteen digitally designed complete removable dental prostheses.MethodsSeveral systems are now available including the Wieland® Digital Denture® which offers a complete procedure. This system is composed of a five axis-milling machine combined with a laboratory scanner and a design software application. Fifteen rehabilitations were carried out using the Wieland® system.ResultsThe practitioner’s role is simplified by intraoral recording with a central point and a reduced number of sessions. The prosthesis laboratory requires considerable investment in learning and equipment, making it possible to obtain ideal mounting assemblies in accordance with the occluso-prosthetic concept of bilateral balanced occlusion. The absence of polymerization and therefore of base deformation risks reduce the equilibration step. Finally, the creation of templates as an alternative to the assembly of teeth on wax makes it possible to functionally validate (masticatory and phonatory) the future dentures. However, this procedure still presented some limitations in terms of scanning and software scope of applications. ConclusionDigital denture design software is relatively efficient and helps to standardize clinical results. However, to this date, improvements of the software are still required for a routine use.

Applying intraoral scanner to residual ridge in edentulous regions: in vitro evaluation of inter-operator validity to confirm trueness

“…The development of methods of border molding using intraoral scanners and devices that can acquire data in mobile regions are awaited. Due to these issues, at present, intraoral scanners are used in edentulous patients for preliminary impressions, after which individual trays are fabricated based on those data and functional impressions are made using conventional methods [39]. In free end saddles, intraoral scanners can be used to make anatomic impressions of residual teeth and residual mucous membrane, from which data a metal framework is fabricated and functional impressions are made using the altered cast technique [40].…”

Full Digital Workflow for the Treatment of an Edentulous Patient with Guided Surgery, Immediate Loading and 3D-Printed Hybrid Prosthesis: The BARI Technique 2.0. A Case Report

“…The patient was 57 years old and presented edentulous maxilla and mandible and was classified as ASA 1 (according to the American Society of Anesthesiologists Physical Status Classification System) as he had no significant systemic disease, and he was not taking any medication. The patient received the maxillary and the mandibular dentures according to the Computer-Aided Design-Computer Aided Manufacturing (CAD/CAM) Denture protocol (Figures 1-5) [15,16].…”

Combining Intraoral and Face Scans for the Design and Fabrication of Computer-Assisted Design/Computer-Assisted Manufacturing (CAD/CAM) Polyether-Ether-Ketone (PEEK) Implant-Supported Bars for Maxillary Overdentures

“…In this sense, the use of face scanning can certainly help, in order to provide the technician with the information necessary for modeling, based on the information on the patient's face [37]. The construction of the overdenture in CAD/CAM, as well as that of the complete denture, starting with intraoral scanning, is essentially burdened by two practical problems: (a) the need to capture the scans of the arches in the correct vertical dimension of occlusion and thus in the proper spatial relationships and (b) the need (especially with the conventional removable denture) to obtain impressions that are correctly functionalized [38, 39]. Functionalization means the ability to record all the details of muscle insertions and frenula also in activity, which has always been a key in the making of a complete denture [38, 39].…”

“…The construction of the overdenture in CAD/CAM, as well as that of the complete denture, starting with intraoral scanning, is essentially burdened by two practical problems: (a) the need to capture the scans of the arches in the correct vertical dimension of occlusion and thus in the proper spatial relationships and (b) the need (especially with the conventional removable denture) to obtain impressions that are correctly functionalized [38, 39]. Functionalization means the ability to record all the details of muscle insertions and frenula also in activity, which has always been a key in the making of a complete denture [38, 39]. As one might guess, it is very difficult if not impossible to capture optical impressions with IOS that are functionalized; the IOS, by definition, cannot capture dynamic changes in the soft tissues [38].…”