Digital tools and 3D printing technologies integrated into the workflow of restorative treatment: A clinical report

The development of technologies including intraoral scanners, dental software for digital restoration design, and additive manufacturing has improved the digital workflow of restorative treatment. The present article describes a digital workflow with intraoral scanning, computer-aided design (CAD) software, and subtractive and additive manufacturing procedures for a patient receiving lithium disilicate laminate veneers.     

Facially generated and additively manufactured baseplate and occlusion rim for treatment planning a complete-arch rehabilitation: A dental technique

Computer-aided design and computer-aided manufacturing (CAD-CAM) technologies have been successfully integrated into the digital workflow to treat completely edentulous patients. However, the digital design and manufacturing technique of the baseplate and occlusion rims have not yet been developed into the digital workflow. This article describes a novel digital workflow using extraoral digitizing procedures, open-source CAD software, and additive manufacturing technologies to obtain a 3D patient. This virtual patient can then be used to plan treatment for a completely edentulous patient, with which the maxillary baseplate and occlusion rims are digitally designed. The workflow allows the digital determination of tooth exposure at rest, the dental midline, the location of the canines, and the determination of the occlusal plane related to the Camper plane. The digital determination of these parameters increases the predictability of the treatment, reducing laboratory and clinician time and costs.     

Obtaining reliable intraoral digital scans for an implant-supported complete-arch prosthesis: A dental technique

This article describes a technique for obtaining an accurate complete-arch digital scan for an edentulous patient. To achieve this, an auxiliary polymeric device that simulates a denture is designed, fabricated, and placed in the mouth. This device, having the geometry of a typical dental arch, facilitates the digitalization of the edentulous complete arch. This is because the change in radius of the curvature (change of geometry) enables the scanner to perform a more accurate alignment. Initially, the necessary location of the implants is acquired, and then the soft tissue is added. This technique can achieve accurate complete-arch digital scans. Distances between implants are closer to the gold standard when using this auxiliary geometry piece than those obtained without using it.     

Stereophotogrammetric impression making for polyoxymethylene,milled immediate partial fixed dental prostheses

Immediate post-extraction and same-day placement of interim prostheses have increased patient acceptance of implant-supported prostheses. However, for immediate prostheses supported by multiple implants, meeting passive fit and esthetic standards is often challenging. In this clinical report, implant photogrammetry was combined with conventionally obtained digitized casts to prepare an interim, milled prosthesis from a polyoxymethylene (POM) disk, using computer-aided design and computer-aided manufacturing techniques. The following 2 conclusions were drawn. First, stereophotogrammetric scanning appears to be a reliable method for making impressions of immediate, implant-supported partial prostheses, and second, POM is suitable for preparing immediate interim screw-retained prosthetic implants.     

Influence of remaining coronal tooth structure on fracture resistance and failure mode of restored endodontically treated maxillary incisors

Statement of problem

Limited information is available on the effect of an incomplete ferrule because of the varying residual axial wall heights and the volume of residual tooth structure on the fracture resistance of endodontically treated and restored maxillary incisors.

Accuracy analysis of complete-arch digital scans in edentulous arches when using an auxiliary geometric device

Statement of problem

Obtaining reliable digital scans of edentulous patients is challenging because of the absence of anatomic landmarks/geometric variations along the dental arch. Whether adding an auxiliary geometric device (AGD) will improve scanning is unclear.

Optimal number of implants for complete-arch implant-supported prostheses with a follow-up of at least 5 years: A systematic review and meta-analysis

Statement of problem

Consensus is lacking regarding the optimal number of implants for supporting complete-arch prostheses with good survival rates and lower prosthetic complications and marginal bone loss.

Minimizing the discrepancy between implant platform and alveolar bone for tilted implants with a sloped implant platform: A clinical report

In a patient with edentulism, distally tilted implants with a novel sloped implant platform were used to minimize the discrepancy between the implant platform and alveolar bone crest and to restore complete-arch monolithic zirconia implant-supported fixed prostheses.     

Feasibility of using an intraoral scanner for a complete-arch digital scan

Statement of problem

The introduction of intraoral scanners has increased the use of digital technology in dental procedures. However, research on the extent of clinically recommended scans is lacking.

Retrospective,cross-sectional study on immediately loaded implant-supported mandibular fixed complete-arch prostheses fabricated with the passive fit cementation technique

Statement of problem

Mandibular fixed complete-arch dental prostheses on dental implants have been benefiting patients for a long time, but problems with passive fitting between the metallic framework of the prostheses and the implants might influence its long-term success.

Antibacterial activity against Streptococcus mutans and diametrical tensile strength of an interim cement modified with zinc oxide nanoparticles and terpenes: An in vitro study

Statement of problem

Interim restorations are occasionally left in the mouth for extended periods and are susceptible to bacterial infiltration. Thus, dental interim cements with antibacterial properties are required.

Prosthetic management of implants placed with the socket-shield technique

Partial extraction therapies, such as the socket-shield technique, use the patient's tooth tissues and periodontium to preserve the alveolar ridge and limit postextraction resorption. Internal exposure through the overlying peri-implant mucosa has been reported as the most common complication, suggesting that the preparation technique requires modification. This technique report describes the prosthetic management of the socket-shield technique, emphasizing preparation of the socket-shield to the bone crest, and the creation of an S-shape prosthetic emergence profile to support maximal soft tissue infill.     

Accuracy of three digital workflows for implant abutment and crown fabrication using a digital measuring technique

Statement of problem

The accuracy of a full digital workflow using an Atlantis abutment and a milled zirconia crown; a full digital workflow with a 3Shape split-file workflow using a zirconia abutment and crown; and an interrupted digital workflow using an Atlantis abutment and a milled zirconia crown is unclear.

Layperson’s preference regarding orientation of the transverse occlusal plane and commissure line from the frontal perspective

Statement of problem

Facial asymmetries in features such as lip commissure and interpupillary plane canting have been described as common conditions affecting smile esthetics. When presented with these asymmetries, the clinician must choose the reference line with which to orient the transverse occlusal plane of the planned dental restorations.

A device to improve fabrication of a conversion prosthesis for immediate loading of dental implants

A common challenge of fabricating a conversion prosthesis for immediate loading of dental implants is preventing the acrylic resin from flowing over the polished metal cuff of the titanium cylinders. Excess acrylic resin that accidentally flows over the polished metal cuff and adheres to it can impede insertion and the proper fit of the conversion prosthesis after surgery. Subsequent removal of the excess acrylic resin using rotary or hand instruments can scratch and damage the polished metal cuff, resulting in increased plaque accumulation and subsequent inflammation and the potential for hard and soft tissue loss during the early stages of healing. This article describes a novel device, a conversion cap, that can be screwed into the titanium cylinders to prevent any acrylic resin from flowing over the polished metal cuff. In addition, it can be attached during finishing and polishing the conversion prosthesis or definitive prosthesis to eliminate any risk of scratches over the metal cuff and allow dental laboratory technicians and clinicians to improve the quality of the prostheses.     

Interim rehabilitation of occlusal vertical dimension using a double-crown-retained removable dental prosthesis with polyetheretherketone framework

Polyetheretherketone (PEEK) is a polymeric material that has recently been introduced in dentistry and can be used as framework material for fixed and removable dental prostheses. This clinical report describes the fabrication of a double-crown–retained prosthesis with a PEEK framework in a patient with a substantially diminished occlusal vertical dimension. The insertion of the removable dental prosthesis with a PEEK framework resulted in the functional and esthetic rehabilitation of the patient; however, removable dental prostheses fabricated from PEEK should currently be regarded as interim restorations because of the limited available scientific evidence.     

Functional and esthetic restorative treatment with preheated resins in a patient with ectodermic dysplasia: A clinical report

Ectodermal dysplasia is a heterogeneous genetic condition affecting 1.6 to 22 per 100 000 people. Oral manifestations associated with this condition include hyperdontia, hypodontia, microdontia, and conical teeth. Traditional treatment consists of a combination of orthodontic and rehabilitation therapies. The initial treatment stage uses removable prostheses and interim crowns for long periods, thus increasing risks for developing secondary caries. This clinical report describes the use of direct composite resin bonding with preheated compactable resins applied to vacuum-formed trays filled with clear silicone. This restorative treatment provides predictable, inexpensive, minimally invasive, functional, and esthetic recovery before orthodontic treatment.     

A two-step functional impression technique for the fabrication of an implant-retained silicone auricular prosthesis

Excessive movement of the underlying tissue bed can lead to poor retention of an implant-retained silicone auricular prosthesis. This article describes a 2-step impression technique with a secondary functional pickup impression of the wax pattern. A wide range of tissue movements can be recorded while maintaining a stable relationship between the abutment analog assembly and retentive elements. The definitive cast is modified accordingly to provide an accurate reproduction of the patient’s tissues during function, thus, increasing the overall retention and stability of the definitive prosthesis.     

Oral features and computerized rehabilitation of a young patient with CHARGE syndrome using minimally invasive long-term interim CAD-CAM restorations

Patients with CHARGE syndrome (where CHARGE stands for coloboma of the iris or retina, heart defects or cardiac malformations, atresia/stenosis of the choanae, retardation of growth and development, genital anomalies, and ear abnormalities) present several orofacial anomalies. Their treatment depends on the specific type of manifestation. To perform the complex oral rehabilitation and achieve a conservative, esthetic, and functional exploration of the definitive treatment goal, computer-aided design and computer-aided manufacturing (CAD-CAM) polymers can be used as long-term interim restorations. This article reports the treatment of a young patient with CHARGE syndrome combined with oral alterations. CAD-CAM polymers offer an intermediate treatment with satisfying esthetics and function at low biological cost until bone growth is completed. This period facilitates additional planning for the definitive restoration.