ABSTRACT
The aim of this case report was to introduce the clinical use of a prosthetic soft tissue level implant and a completely digitized workflow for the production of an individualized suprastructure fixated on prosthetic implants for orthodontic anchorage reinforcement. A prosthetic soft tissue level implant was placed in the palatal region for orthodontic anchorage reinforcement. Based on an intraoral optical scan taken after implant osseointegration, the orthodontic suprastructure was manufactured entirely by means of computeraided design and manufacturing (CAD/CAM). The individualized suprastructure was subsequently loaded in direct manner. The prosthetic implant was then removed in a noninvasive manner, similar to palatal implants.The analysis included clinical and laboratory fabrication steps. The placement of prosthetic implant in the palatal region proved to be a painless, easy and fast procedure, and provided absolute anchorage during the entire intended orthodontic treatment. Its noninvasive removal did not cause any adverse patient reactions. The digitally constructed suprastructure did not require any chairside adaptation at delivery and was successfully used for the intended orthodontic treatment.The reported case presents the successful placement, loading and removal of a prosthetic soft tissue level implant for orthodontic anchorage use in the palatal region. The described digital and modelfree workflow provides a feasible and streamlined treatment modality for the fabrication of individualized orthodontic suprastructures by means of CAD/CAM for the use as orthodontic anchorage reinforcement. This proof of principle should be substantiated with further largerscaled investigations.