Esthetic and functional rehabilitation of a patient with a bilateral cleft of lip, alveolar process, and palate with anterior all-ceramic cantilever resin-bonded fixed dental prostheses.

OBJECTIVES: Addressing a single-tooth gap in the anterior region, resulting from aplasia or trauma, poses both esthetic and functional challenges. This case report presents the restoration of a young adult with a cleft, exhibiting anterior hypoplasia and aplasia in the canine and incisor regions, using all-ceramic cantilever resin-bonded fixed dental prostheses. METHOD AND MATERIALS: After verification of esthetic and functional considerations through a diagnostic wax-up and an intraoral mock-up, three anterior all-ceramic cantilever resin-bonded fixed dental prostheses made of veneered zirconium dioxide were planned in the region of the maxillary right lateral incisor and maxillary left canine. The impression was made with an intraoral scanner. The framework fit was evaluated. Glaze firing and full adhesive cementation under rubber dam followed. RESULTS: The final restoration met the patients' expectations and restored facial esthetics and function. CONCLUSIONS: All-ceramic cantilever resin-bonded fixed dental prostheses offer a promising minimally invasive therapeutic option for cleft patients.

Digitization of One-Piece Oral Implants: A Feasibility Study.

For digital impression-making of two-piece oral implants, scan bodies are used to transfer the exact intraoral implant position to the dental laboratory. In this in vitro investigation, the accuracy of digitizing a one-piece ceramic oral implant without a scan body (OC) was compared to that of a standard two-piece titanium implant with a scan body (TT) and a preparation of a natural single tooth (ST). Furthermore, incomplete scans of OC simulating clinical compromising situations (OC1-4) were redesigned using a virtual reconstruction tool (RT) and superimposed to OC. OC and TT oral implants and one ST were inserted into a mandible typodont model and digitized (N = 13) using two different intraoral scanners. The resulting virtual datasets were superimposed onto a three-dimensional (3D) laser scanner-based reference. Test and reference groups were aligned using an inspection software according to a best-fit algorithm, and circumferential as well as marginal discrepancies were measured. For the statistical evaluation, multivariate analyses of variance with post-hoc Tukey tests and students t-tests to compare both scanners were performed. A total of 182 datasets were analyzed. For circumferential deviations, no significant differences were found between ST, TT, and OC (p > 0.964), but increased deviations for OC1-4 (p < 0.001) were observed. The measurements of the marginal deviations revealed that ST had the smallest deviations, and that there were no significant differences between TT, OC, and OC1-4 (p > 0.979). Except for marginal deviation of OC (p < 0.001), the outcome was not affected by the scanner. Within the limitations of this study, digitization of OC is as accurate as that of TT, but less than that of ST. In the case of known geometries, post-processing of compromised scans with a virtual reconstruction results in accurate data.