Fixed prosthodontic rehabilitation of a patient after bariatric surgery using a facially driven fully digital workflow: A clinical report with a 3-year follow-up.

Patients who have received bariatric surgery have specific and complex dental needs. After surgery, nutrient deficiencies, osteoporosis, gastroesophageal reflux, and changes to the oral cavity may be seen, and erosion, caries, wear, xerostomia, hypersensitivity, and changes to the salivary buffering capacity may occur. In addition, patients are advised to ingest smaller, more frequent, meals throughout the day, and the oral condition may decline rapidly after surgery. Without oversight, this accelerated decline may even necessitate complete mouth rehabilitation postoperatively. Dental providers should be an integral part of the multidisciplinary management team of these patients. This clinical report describes a patient with a terminal dentition following bariatric surgery who underwent prosthodontic rehabilitation with a facially driven fully digital workflow.

Prosthodontic rehabilitation of two siblings with hypoplastic (type 1) amelogenesis imperfecta: A case report.

Amelogenesis imperfecta is a rare genetic disorder that interferes with normal enamel formation. Of the 4 main types of amelogenesis imperfecta, hypoplastic (type 1) is the most prevalent, characterized by a quantitative alteration in enamel. The pitting or reduced thickness of the enamel results in generalized hypersensitivity, increased susceptibility to caries and infection, attrition, and a loss in vertical dimension of occlusion. Prosthodontic management of these patients can be challenging not only functionally and restoratively, but also from an emotional and psychosocial standpoint. This clinical report describes the prosthodontic management and rehabilitation of two young adult siblings with hypoplastic (type 1) amelogenesis imperfecta.

Partial Extraction Therapy (Part 1): Applications in Full-Arch Dental Implant Therapy.

Partial extraction therapy (PET) is a set of surgical techniques that preserve a portion of the patient's own root structure to maintain blood supply derived from the periodontal ligament complex in order to maintain the periodontium and peri-implant tissues during restorative and implant therapy. PET includes the socket shield technique (SST), proximal shield technique (PrST), pontic shield technique (PtST), and root submergence technique (RST). In a traditional hybrid technique, total extraction and full-arch dental implant therapy often require significant bone reduction and palatal/lingual implant placement. In addition, postextraction preservation of the ridge architecture is a major challenge. This case series demonstrates the use of a combination of PET techniques with digital implant planning and guided implant surgery to achieve highly esthetic outcomes in full-arch implant therapy.

Partial Extraction Therapy (Part 2): Complication Management in Full-Arch Dental Implant Therapy.

Partial extraction therapy (PET) is a group of surgical techniques that preserve the periodontium and peri-implant tissues during restorative and implant therapy by conserving a portion of the patient's own root structure to maintain the blood supply, derived from the periodontal ligament complex. PET includes the socket shield technique (SST), proximal shield technique (PrST), pontic shield technique (PtST), and root submergence technique (RST). Although their clinical success and benefits have been demonstrated, several studies report possible complications. The focus of this article is to highlight management strategies for the most common complications associated with PET, including internal root fragment exposure, external root fragment exposure, and root fragment mobility.

Fixed prosthodontic rehabilitation for an adult with ectodermal dysplasia using a completely digital workflow.

This clinical report describes the fixed prosthodontic treatment of an adult patient with ectodermal dysplasia by using a completely digital workflow, from the initial consultation appointment to the fabrication of the definitive implant-supported prostheses.

Fixed prosthodontic rehabilitation for an adolescent patient with ectodermal dysplasia using a fully digital workflow: Two-year follow-up.

Ectodermal dysplasia is a rare genetic disorder characterized by congenital abnormalities of tissues and structures of ectodermal origin, such as the hair, nails, skin, sweat glands, and teeth. Common dental characteristics include retained primary teeth, conical shaped incisors and canines, and hypodontia or oligodontia. Early prosthodontic intervention of young patients diagnosed with ectodermal dysplasia is essential as symptoms can have substantial esthetic, functional, and psychosocial impacts. This clinical report describes the fixed prosthodontic treatment of an adolescent patient with ectodermal dysplasia by using a fully digital workflow. Digital workflows streamlined the treatment process and allowed for esthetic, functional, and psychological improvements in an efficient manner.

A Digital Approach to Immediate-Load, Full-Arch Implant Dentistry: A Case Report.

Conventional approaches to full-arch implant dentistry require a verified master model created by luting together impression jigs. This process involves numerous steps and is sometimes prone to errors that require subsequent correction. A novel approach involving an extraoral scanning technique using an Imetric 4D Imaging system demonstrates an alternative for same-day delivery of printed full-arch prosthetics. Advantages include the ability to offer a same-day provisional restoration without needing to verify an analog master cast.

Screw-retained surgical guide for implant placement in terminal dentition patients with existing implants.

For patients with existing implants in need of additional implant placement, the use of the existing implants for guide fixation seems to be a logical alternative. Current options for the fabrication of surgical guides involve creating surgical guides that are mucosa-borne and/or retained by fixation pins. Since these existing techniques involve inherent inaccuracies, the fabrication of surgical guides that are screw-retained at the implant- or abutment-level would eliminate the introduction of those same fundamental inaccuracies. The purpose of the present technical report is to illustrate a step-by-step digitally planned guided implant placement protocol for terminal dentition patients with salvageable existing implants requiring full-arch implant rehabilitation. The advantages of this protocol include enhancing the accuracy of guided implant placement with screw-retention versus the traditional mucosa- or fixation pin support. Thus, this simplifies the transition from failing teeth to implants by ensuring that fixed provisionalization serves both functional and esthetic requirements. This protocol can also predictably reduce chairside time and adjustments at the surgical implant placement appointment.

Fixed prosthodontic rehabilitation with a fully digital workflow for a teenage patient with amelogenesis imperfecta: A 2-year follow-up.

Amelogenesis imperfecta is a hereditary disorder that affects the enamel formation of the primary and permanent dentition and has significant consequences because hypersensitivity causes difficulty with oral hygiene, function, self-esteem, and quality of life. Patients diagnosed with amelogenesis imperfecta often require extensive treatment, often at an early age. Prosthodontic intervention of adolescent patients with amelogenesis imperfecta presents specific clinical challenges. This clinical report describes the fixed prosthodontic rehabilitation of a teenage patient with amelogenesis imperfecta by using a fully digital workflow throughout the treatment process, which facilitated functional, biomechanical, esthetic, and sociopsychological improvements.

Combined bone- and mucosa-supported 3D-printed guide for sinus slot preparation and prosthetically driven zygomatic implant placement.

The use of zygomatic implants to rehabilitate the severely atrophic maxilla has been well documented since first being introduced by Brånemark. Placement of zygomatic implants is technically complex, with catastrophic complications and numerous prosthetic challenges resulting from imprecise placement. The purpose of this report was to demonstrate a technique that allows transfer of the preoperatively planned sinus slot position to the surgical field by using cone beam computed tomography (CBCT) and an implant planning software program to fabricate a combined bone- and mucosa-supported 3D-printed surgical guide. This facilitates optimal zygomatic implant positioning and promotes favorable biomechanics with a predictable prosthetic outcome.

Digitally Designed and Milled Verification Jigs Generated from Photogrammetry Data Acquisition: A Clinical Report.

The objective of the present report is to illustrate a proof-of-concept protocol for CAD/CAM fabrication of milled verification jigs during full-arch implant rehabilitation using photogrammetry for data acquisition. The present report aims to bridge the gap between analog and digital workflows by introducing a CAD/CAM technique to intraorally verify digitally acquired information without the use of the technique-sensitive and labor-intensive conventional resin verification jig. One patient was treated with a digital prosthodontic protocol where a digitally designed CAD/CAM milled verification jig (generated from intraoral digital scans) was used to confirm implant 3D positioning prior to the fabrication of double full-arch monolithic definitive zirconia prostheses. The procedures are presented step-by-step after clinical and radiographic observation.

Digital surgical planning and placement of osseointegrated implants to retain an auricular prosthesis using implant software with cone-beam computed tomography and 3D-printed surgical guides: A case report.

Integration of CBCT imaging with dental implant treatment planning software and 3D-printed surgical guides can facilitate surgical planning for extraoral implant placement. In the current case, this combined planning strategy enabled navigation of challenging osseous anatomy, avoided critical structures, and optimized osseointegration for prosthesis retention.

A 3D-Printed Guide to Assist in Sinus Slot Preparation for the Optimization of Zygomatic Implant Axis Trajectory.

Zygomatic implants have become a predictable treatment modality for the rehabilitation of the severely atrophic maxilla. Due to differing anatomic variations, proximity to vital anatomic structures and limited intraoperative visibility, the placement of zygomatic implants can be a difficult task; compromised implant positioning may ultimately lead to postoperative surgical and prosthetic complications. The purpose of this report is to demonstrate a technique that allows for the transfer of the sinus slot position. Ultimately, this optimizes zygomatic implant axis trajectory from preoperative prosthetic planning by using cone beam computed tomography (CBCT) and 3-dimensional (3D) planning software to fabricate a stereolithographic 3D-printed surgical guide.

All-on-4® Treatment Concept in a Severely Resorbed Jaw Using Narrow-Platform Implants: A Case Report.

Although many approaches to the restoration of edentulous maxillae and mandibles have been developed, these treatments can be costly and time-consuming, and involve extensive grafting of the edentulous ridges. The All-on-4® treatment concept has been shown to be a viable alternative, with limited grafting required, using at least four regular-platform implants to support an acrylic, screw-retained provisional prosthesis before the fabrication of a definitive prosthesis. This case presentation will discuss the use of narrow-platform (3.5-mm) implants to provide a patient with a screw-retained acrylic provisional on the day of implant placement.

Crystal engineering rescues a solution organic synthesis in a cocrystallization that confirms the configuration of a molecular ladder.

Treatment of an achiral molecular ladder of C(2h) symmetry composed of five edge-sharing cyclobutane rings, or a [5]-ladderane, with acid results in cis- to trans-isomerization of end pyridyl groups. Solution NMR spectroscopy and quantum chemical calculations support the isomerization to generate two diastereomers. The NMR data, however, could not lead to unambiguous configurational assignments of the two isomers. Single-crystal X-ray diffraction was employed to determine each configuration. One isomer readily crystallized as a pure form and X-ray diffraction revealed the molecule as being achiral based on C(i) symmetry. The second isomer resisted crystallization under a variety of conditions. Consequently, a strategy based on a cocrystallization was developed to generate single crystals of the second isomer. Cocrystallization of the isomer with a carboxylic acid readily afforded single crystals that confirmed a chiral ladderane based on C(2) symmetry. The chiral ladderane and acid self-assembled to generate a five-component hydrogen-bonded complex that packs to form large solvent-filled homochiral channels of nanometer-scale dimensions. Whereas cocrystallizations are frequently applied to structure determinations of proteins, our study represents the first application of a cocrystallization to confirm the relative configuration of a small-molecule diastereomer generated in a solution-phase organic synthesis.

General application of mechanochemistry to templated solid-state reactivity: rapid and solvent-free access to crystalline supermolecules.

Supermolecules with olefins organized by hydrogen-bond donor and acceptor templates and that react in the solid state rapidly form co-crystals via solvent-free and liquid-assisted grinding.