前牙区数字化即刻种植即刻修复病例报道及文献回顾

目的：报道以修复为导向的上前牙美学区数字化即刻种植即刻修复技术。方法通过口内数字化光学扫描印模,结合CBCT扫描,CAD/CAM技术虚拟植入种植体、设计个性化钛基台穿龈形态及临时修复体,并生成种植手术导板及临时牙,辅助完成微创手术。结果本技术达到拔牙后即刻种植即刻修复的效果。即刻修复临时牙冠能够在病人第二次就诊手术后即刻完成,最终实现保存软组织轮廓的美学种植修复。结论种植应用数字化技术改变了以往工作流程,使美学种植修复更加简单、高效、精确。     

A completely digital workflow for an interim implant-supported crown: A clinical report

This article describes a completely digital workflow for the diagnostic phase, surgical and prosthetic planning, extraction, immediate single implant placement by guided surgery, and interim implant-supported crown. From a virtual impression, zirconia abutments and a polymethylmethacrylate (PMMA) interim crown was planned in a computer-aided design (CAD) software program. This workflow shortened the time required for chairside placement of an interim restoration with enhanced function and esthetics while restoring an anterior mandibular tooth lost after trauma.     

Denture scanning technique for computer-guided implant-supported restoration treatment of edentulous patients

The traditional protocol for guided surgery in a completely edentulous patient is time-consuming, requiring the fabrication of a radiographic guide and a dual cone beam computed tomography (CBCT) scan. Using intraoral scanners to scan the edentulous ridge and the existing denture has been advocated to simplify the process. This technique offers a versatile, precise, and predictable method for the digital planning workflow in edentulous patients for either a fixed or removable restoration. In addition, this approach can help improve the quality of the guide produced by reducing CBCT artifacts associated with the existing denture, as well as capture the soft-tissue contour to further improve the fit of the surgical guide.     

Full‐Arch Implant‐Supported Rehabilitation Guided by a Predicted Lateral Profile of Soft Tissue

In full‐arch implant‐supported rehabilitation of patients with severe periodontitis, prediction of lateral facial profile with modified dental position remains a challenge, especially for patients with protruded anterior teeth. This clinical report describes a digital workflow to predict lateral profiles and then guide the implant placement and restoration fabrication.     

Surgical oral radiographic guide with a removable component for implant placement

Radiographic guides are essential for optimal implant positioning. Surgical guides permit implants to be placed in preselected positions and at proper angulations. This article describes a procedure for combining the functions of radiographic and surgical guides in a single device. The radiographic component is easily separated from the surgical component after the necessary radiographs have been made. This procedure results in less paraphernalia and reduces costs since only 1 basic guide with an add-on component is fabricated.     

Digital planning for two-implant-supported overdenture and bone reduction guide using cone-beam computed tomography: Simple features for predictable outcomes

The two-implant-supported mandibular overdenture is considered a reliable treatment option to restore masticatory function. Digital planning has been shown to improve the precision and accuracy of the surgical procedure. The outcomes are indeed pertinent to the ideal three-dimentional positioning of the implant placement. Recently, the uses of cone-beam computed tomography (CBCT) and intraoral scan have improved greatly the workflow of digital planning; however, the sophisticated technology caused confusion among clinicians. The purpose of this case series was to exhibit the efficacy of a bone-supported guide in applying simultaneous implant placement and bone reduction, solely based on CBCT data. The bone reduction can therefore be determined accordingly, by adding windows to the guide, allowing the clinician to decide the amount of bone reduction as well as the location for implant placement. This novel surgical guide would not only fit properly on the bone but also provide the benefits of less-invasive surgery and the opportunity to place implants parallel. The  digital workflow described not only simplifies the fabrication process but also yields predictable surgical outcomes.     

Cast-based guided implant placement: a novel technique

One of the most challenging aspects of implant placement is the correct spatial positioning of the dental implant in the bone. Surgical guides of various configurations have been proposed to aid implant placement. If a fully limiting surgical guide is used, the encoded information should be reliable, as deviations are not possible during surgery. This article describes a combination of analog techniques, including bone sounding and periapical radiographs used to study the available bone volume. A simplified casting protocol is proposed, and the implant platform position of the implant analog is transferred to a surgical guide composed of a stiff vinyl polysiloxane material. This surgical guide is used in a conventional flapless guided implant surgery protocol. This combination of techniques allows precise placement of a dental implant, abutment, and provisional restoration in a minimally invasive manner.     

Case report: temporary restoration for a single tooth implant prosthesis with adverse axial inclination of the fixture

Providing an acceptable temporary restoration can be a challenge on a single implant where surgical considerations have dictated an adverse axial alignment. Prefabricated temporary abutments do not incorporate compensation for such implant positions. A temporary restoration can serve multiple functions. This case report describes a technique to provide an acceptable temporary restoration for a malaligned single tooth implant.     

Simplistic partially limiting surgical guide for flapless implant placement: a case report

The accurate positioning of implant in bone is important in order to meet the biological, esthetic, and biomechanical requirements of the prosthesis. This becomes crucial in flapless implant placement. The combination of bone sounding and use of a surgical guide will allow precise placement of a dental implant, abutment, and provisional restoration in a minimally invasive manner. A technique to transfer the diagnostic information to the surgical guide is described in this report. The chief advantage of the procedure is the ability to apply flapless implant placement surgery and immediate loading.     

A Novel Simplified Workflow for Guided Endodontic Surgery in Mandibular Molars With a Thick Buccal Bone Plate: A Case Report

One of the challenges in apical surgery in mandibular molars is the thick buccal cortical bone plate, which might lead to access errors, damage to neighboring teeth, and injury to healthy tissue. Surgical guide templates with 3-dimensional (3D) impressions have been suggested for use in such cases, allowing greater precision. Usually, this technique involves a cone-beam computed tomography (CBCT) examination related to a 3D oral scanning to generate surgical templates printed from 3D imaging data. This study reports a novel workflow possibility in which apical surgery is performed with the aid of a surgical guide planned only with CBCT, excluding the need for 3D oral scanning. A 32-year-old woman presented with asymptomatic apical periodontitis and external root resorption on the mesial root of tooth #19. A surgical template was planned using only the patient's CBCT scan to provide precise access to the lesion and remove a mandibular cortical bone block. The procedure was carried out with apicoectomy, root-end preparation, and retrograde filling, and the bone block was repositioned before suture. No postoperative complications were reported. After 1 year, the patient presented asymptomatic, and a CBCT scan confirmed bone healing. The current 3D-printed guides may be planned and printed through a novel simplified workflow with a CBCT scan only, which allows its application in apical surgery for precise apex and surgical site location.     

Fabricating a chairside CAD-CAM radiographic and surgical guide for dental implants: A dental technique

The conventional method of diagnosing and treatment planning an implant-supported restoration involves making a diagnostic alginate impression and fabricating a radiographic and surgical guide. The procedure described uses an intraoral scanner and milling unit to fabricate a chairside computer-aided design and computer-aided manufacturing radiographic and surgical guide for use with a cone beam computed tomography system.     

Fabrication and use of a simple implant placement guide

Proper placement and orientation of dental implants is a requirement for optimum function and esthetics to be obtained with the definitive restoration. This article describes an acrylic resin implant placement guide which is simple to fabricate and easy to use. This device guides the surgeon in the precise position and angulation planned for the implant, yet allows for some flexibility in the event slight adjustments are necessary during surgery.     

Prosthodontic and Surgical Management of a Completely Edentulous Patient with a Severe Class III Skeletal Maxillomandibular Relationship: A Clinical Report

This article describes a multidisciplinary approach combining surgical and prosthodontic treatment of a completely edentulous patient who presented with a severe skeletal class III relationship and was diagnosed as American College of Prosthodontists Prosthodontic Diagnostic Index (ACP PDI) class IV. The use of a complete denture serving as diagnostic tool, surgical guide, and definitive restoration is presented. Computer‐aided surgical simulation was used to achieve an accurate diagnostic and surgical plan. Maxillary Lefort class I and mandibular sagittal split osteotomy surgical treatment was performed to correct arch discrepancy. The surgical procedure demonstrated a clinically acceptable maxillomandibular relationship and stability. The patient was satisfied with the esthetics and demonstrated improved oral function following prosthesis insertion.     

数字化导板在口腔种植中的应用

迄今,种植义齿修复已成为有效治疗牙列缺损、缺失,恢复口腔咀嚼功能的重要方法。同时,三维影像成像技术和快速成型技术的发展极大地推动了数字化种植技术的普及。本文将对数字化种植导板的设计流程、不同类型患者的导板设计要点、数字化导板误差及导板国产化的发展前景等方面,进行详细阐述。     

Use of a cross-mounting buccal index to help transfer the spatial relationships of an interim prosthesis to the definitive implant-supported prosthesis

This article describes a new method for the fabrication of an index for definitive implant abutment selection, framework design, and fabrication. After the interim removable restoration is esthetically and functionally accepted by the patient and dentist, it can be used as a surgical guide during implant placement as well as a guide for abutment selection, framework design, and fabrication. The concepts used in the fabrication of the cross-mounting buccal index include having a reference point, maintaining the vertical dimension of occlusion, and supplying the ability for cross mounting. This procedure allows the clinician to use a duplicate of the interim restoration to select the abutments and fabricate the framework without a new denture setup. It also accelerates both patient chairtime and laboratory time, and it enhances the prosthodontic outcome.     

Comparison of two computer-assisted surgery techniques to guide a mandibular distraction osteogenesis procedure. Technical note

The accuracy of distracted facial bone displacement depends on the preoperative clinical assessment, surgical planning and technique. The aim of this study was to evaluate two different techniques to guide the mandibular distraction surgical procedure using an intraoral device. This study was performed on a fresh cadavre. 3D reconstructions from a computed tomographic (CT) acquisition were used for the two techniques. The first technique comprised a customised stereolithographic template and the second technique used a computer-assisted surgery (CAS) unit to guide the osteotomy and the positioning and screwing of the distractor device. Both methods were planned and compared with the same 3D software. The authors discuss the feasibility and reliability of the two techniques. The accuracy of the two techniques appears to be comparable for clinical applications, although the rapid prototyping template technique appears to be more satisfactory.     

Digital Workflow for Retrofitting a Surveyed Crown Using a Removable Partial Denture as an Antagonist

Digital workflow expedites the procedure of retrofitting a surveyed crown against an existing removable partial denture (RPD). This article describes a simple and straightforward technique of digital workflow where an existing RPD is scanned as an antagonist to design the rest seat, guide plane, and height of contour of a surveyed crown.     

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迄今,种植义齿修复已成为有效治疗牙列缺损、缺失,恢复口腔咀嚼功能的重要方法。同时,三维影像成像技术和快速成型技术的发展极大地推动了数字化种植技术的普及。本文将对数字化种植导板的设计流程、不同类型患者的导板设计要点、数字化导板误差及导板国产化的发展前景等方面,进行详细阐述。     

Application of titanium 3D-printed double-sleeve guide for zygomatic implants: A technique report

The unique anatomical structure of the atrophic edentulous maxilla limits the placement of endosteal root form dental implants without bone grafting and augmentation. Surgical placement of zygomatic implants in an optimal position remains challenging. This technique report illustrates a novel digital guide technology, including the design workflow, application method, and indications for assisting with the placement of zygomatic implants using a bone-supported titanium double-sleeve guide. In addition, when the implant body reaches the zygomatic bone following an intra-sinus path, including ZAGA type 0 and ZAGA type 1 cases, a matching window osteotomy surgical guide is used to locate the lateral window boundary and protect the sinus membrane. With this technique, the surgical procedure is simplified, and the precision of guided zygomatic implant placement is improved.     

A multifunctional, provisional, implant-retained fixed partial denture

This article describes the modification of a procedure for fabricating a laboratory-processed, metal-reinforced, acrylic resin provisional restoration that becomes an implant-retained fixed partial denture. The modification involves the incorporation of patrix and matrix components into a cast metal framework. The prosthesis can be used as an alternative to a removable radiologic stent and surgical guide. It can function as a surgical guide during implant placement and help retract the buccal mucogingival flap during implant placement. The prosthesis also can be used as an aid in locating the implant during stage II surgery. Finally, the pontics can be converted into an implant-supported provisional restoration immediately after the implant prosthetic components are attached to the uncovered implants.