From Guided Surgery to Final Prosthesis with a Fully Digital Procedure: A Prospective Clinical Study on 15 Partially Edentulous Patients

Abstract

Scope. To demonstrate guided implant placement and the application of fixed, implant-supported prosthetic restorations with a fully digital workflow. Methods. Over a 2-year period, all patients with partial edentulism of the posterior maxilla, in need of fixed implant-supported prostheses, were considered for inclusion in this study. The protocol required intraoral scanning and cone beam computed tomography (CBCT), the superimposition of dental-gingival information on bone anatomy, surgical planning, 3D-printed teeth-supported surgical templates, and modelling and milling of polymethylmethacrylate (PMMA) temporaries for immediate loading. After 3 months, final optical impression was taken and milled zirconia frameworks and 3D-printed models were fabricated. The frameworks were veneered with ceramic and delivered to the patients. Results. Fifteen patients were selected for this study. The surgical templates were stable. Thirty implants were placed (BTK Safe®, BTK, Vicenza, Italy) and immediately loaded with PMMA temporaries. After 3 months, the temporaries were replaced by the final restorations in zirconia-ceramic, fabricated with a fully digital process. At 6 months, none of the patients reported any biological or functional problems with the implant-supported prostheses. Conclusions. The present procedure for fully digital planning of implants and short-span fixed implant-supported restorations has been shown to be reliable. Further studies are needed to validate these results.

The ball welding bar: a new solution for the immediate loading of screw-retained, mandibular fixed full arch prostheses

“…In the present study, we have used tapered implants with a hexagonal conical implant-abutment connection, because these fixtures had all the features necessary to meet the biological and mechanical requirements for immediate loading, both in fully healed edentulous ridges and in postextraction sockets [12]. The tapered design with double lead threads, in fact, allows the surgeon to obtain an excellent primary implant stability even in difficult clinical conditions [12], such as in the case of postextraction sockets [20].…”

“…The tapered design with double lead threads, in fact, allows the surgeon to obtain an excellent primary implant stability even in difficult clinical conditions [12], such as in the case of postextraction sockets [20]. At the same time, the dual acid etched surface of these implants has the potential to accelerate bone healing, as demonstrated by a recent histologic/histomorphometric human study [13].…”

3D Printing and Digital Processing Techniques in Dentistry: A Review of Literature

“…The software allows to create a visualized image of a commercialized design with a total length of 37 mm, a working length of 18.5 mm and a diameter of 1.5 mm . In addition, a virtual guidance with an inner diameter of 1.5 mm, an external diameter of 2.8 mm and a length of 6 mm is designed for planning aims . Virtual dental drill accumulates on each tooth for direct, simple and easy access to the top third of the root canal .…”

“…In addition, future developments are expected to overcome current obstacles to “static” diagnostics to ensure “dynamic” diagnostics that simulate various functional activities . STL files acquired from intraoral scanning can be step‐by‐step superimposed on the STL files acquired from the reconstruction of CBCT with proprietary so ware for the guidance of surgery planning . CBCT is a needful tool in the diagnosis and treatment of invaginated root canals.…”

“…Surgical and prosthetic 3D planning: a) overlapping of intraoral scan and CBCT; b) overlapping of intraoral scan and CBCT with molded provisional restorations; c) overlapping of intraoral scan and CBCT with modeled provisional restoration and implant planning (occlusal view); d) overlapping of intraoral scan and CBCT with modeled provisional restoration and implant planning (side view); e) implant planning (cross sections); f) implant planning (panorex) …”