In vitro comparative study between complete arch conventional implant impressions and digital implant scans with scannable pick-up impression copings.

STATEMENT OF PROBLEM: Intraoral digital scan techniques have been widely used and sufficient evidence supports this technique in partially edentulous patients. However, the evidence supporting the use of intraoral scanners (IOSs) for edentulous patients is limited. PURPOSE: The purpose of this in vitro study was to measure and compare the accuracy of complete arch conventional pick-up implant impressions with open and closed trays, complete arch digital implant scans with IOSs, and 3-dimensional (3D) printed casts from complete arch digital implant scans. MATERIAL AND METHODS: Six implants were placed in a mandibular model. Scannable pick-up impression copings were inserted in the implants, scanned with a reference scanner, and exported in standard tessellation language (STL) format (Group Control). Splinted open-tray pick-up impressions (Group OT, n=5) and closed-tray pick-up impressions (Group CT, n=5) were made, and stone casts were fabricated. Digital scans (Group DS, n=5) were made with an IOS, and the STL files were exported to fabricate 3D printed casts (Group STL, n=5). Scannable pick-up impression copings were inserted in the dental implant analogs in Groups OT, CT, and STL and scanned with the reference scanner. Using a 3D inspection software program, the recording techniques were compared with the control. Root mean square (RMS) values were calculated from the control, and superimposed digitized casts from different recording techniques. Analysis of variance was used to determine differences in RMS values, and theTukey post hoc test was used to determine difference between different groups. RESULTS: Group CT had the lowest mean dimensional difference when superimposed with Group Control, followed by Groups DS, OT, and STL. Significant differences were found in RMS values between Control and digitized casts fabricated with different techniques (P<.05). The post hoc Tukey test revealed that Group DS (P<.05) was significantly different from the other groups, while no significant difference was found among Groups CT, OT, and STL (P>.05). CONCLUSIONS: Based on the findings of the present study, 3D printed casts from digital scans have the same accuracy as stone casts from conventional impressions in complete arch implant cases. Intraoral scans had the highest accuracy. Complete arch pick-up impression techniques using dual-functioning scannable pick-up impression copings are as accurate as splinted complete arch pick-up impressions.

Fabrication of a Dual-Purpose Implant Surgical Guide.

While surgical guides have allowed for more highly accurate immediate implant placement in the esthetic zone, only a few techniques have been described to predictably position an immediate implant provisional. Even fewer techniques have addressed repositioning a patient's extracted tooth for use as the interim implant restoration. This article describes a workflow for the fabrication of a dual-purpose surgical guide that allows for guidance of implant placement as well as repositioning of a decoronated tooth that will serve as a provisional. While other provisional techniques aim to recreate proper gingival contour, the benefit of repositioning of the original tooth is the preservation of the existing gingival margin position and existing critical contour of the emergence profile.

Digital Full-Mouth Reconstruction: From Diagnostics to Final Full Zirconia Restorations.

BACKGROUND: This clinical report describes the use of digital technology for full-mouth rehabilitation using fixed implant-supported full-contour zirconia prostheses. CASE PRESENTATION: A 61-year-old female patient presented with existing acrylic overdentures retained by mini implants; her chief concern was to improve esthetics and function through the use of fixed prostheses. Digital tools comprising CAD/CAM, 3D printing, guided implant surgery, and 2D smile design were utilized from the planning stage to final restorations combined with analog components in an efficient manner to address the patient's chief concern. Existing mini implants were used to help position surgical guides and provisional restorations. Final restorations were fabricated using a monolithic multilayered full-contour zirconia dental material, which provided excellent physical and esthetic properties. CONCLUSION: Digital technology is an essential component of modern dentistry to achieve predictable outcomes for the treatment of complex cases in an efficient manner.

A novel digital approach for fixed full-mouth implant-supported rehabilitations: A case report.

Successful rehabilitation of a patient's entire dentition with implant-supported fixed prostheses requires restoration of function, esthetics and comfort. To achieve this goal, the clinician and laboratory technician must work in concert with one another to navigate the multiple steps from the patient's initial evaluation to delivery of the final prostheses. Key to this is the ability of the clinician to provide the technician with detailed information regarding the patient's extra- and intraoral characteristics in a manner that can be easily and accurately transferred to the lab bench where it then serves as the foundation for reconstruction of the dentition. In recent years, the impressive evolution of digital technology in dentistry has dramatically facilitated this complex process. The aim of this case report is to illustrate how digital profiles of a patient's facial and intraoral features can be merged with one another and used to generate artificial teeth and gingival tissue of a full mouth implant supported rehabilitation via computer-aided design and computer-aided manufacturing (CAD/CAM) technology to successfully rehabilitate a patient that initially presented with a terminal dentition. Key words:Facial scan, Zirconia, Implant-supported rehabilitation, Implant-supported prosthesis, Fixed prosthesis, Oral rehabilitation.