Digital replication of the peri-implant soft tissue contour of implant-supported crowns: A dental technique

Reconstruction of Gingival Mask around CAD-CAM Bar and Ball Attachment in Implant-Retained Overdenture

Gingival mask is a copy of the peri-implant tissue, which plays an important role in the fabrication of an optimal restoration. Losing the gingival mask is a clinical problem that complicates the process of restoration fabrication. Herein, a simple precise technique is described step by step to solve this problem in the patient with CAD/CAM milled bar and ball attachment treatment plan for a maxillary and a mandibular implant-supported overdenture, without the need to repeat the entire clinical and laboratory procedures.

A double-blind randomized within-subject study to evaluate clinical applicability of four digital workflows for the fabrication of posterior single implant crown

OBJECTIVE

To compare efficiency and clinical efficacy of posterior single implant crowns (PSIC) fabricated using four digital workflows.

MATERIALS AND METHODS

Twenty-two patients with one missing first molar were included. Each patient received four screw-retained implant crowns fabricated through four different workflows including a fully digital workflow with immediate digital impression (Group i-IOS), a fully digital workflow with digital impression after implant osseointegration (Group d-IOS), a model-based hybrid workflow using immediate analogue impression (Group i-AI), and a model-based hybrid workflow with conventional analogue impression after implant osseointegration (Group d-AI). The crown delivery sequence was randomized and blinded. The efficiency for each workflow and clinical outcome of each crown were recorded.

RESULTS

The average clinical working time in fully digital workflows (i-IOS 46.90 min, d-IOS 45.66 min) was significantly lower than that in the hybrid workflows (i-AI 54.59 min, d-AI 55.96 min; p < .001). Significantly more laboratory time was spent in hybrid workflows (i-AI 839.60 min, d-AI 811.73 min) as compared to fully digital workflows (i-IOS 606.25 min, d-IOS 607.83 min, p < .01). No significant differences in the chairside time at delivery were found. More crowns in Group i-AI (15%) needed additional laboratory interventions than in the other groups (p = .029).

CONCLUSION

Digital impression and model-free fully digital workflow improved prosthetic efficiency in the fabrication of PSIC. With the limitation that the results were only applicable to the implant system used and the digital technologies applied, findings suggested that workflows integrating immediate impression with implant surgery procedure was clinically applicable for restoration of PSIC.

Application of virtual technology to maximize esthetics and function in the restoration of anterior traumatic dental injuries

The restoration of multiple teeth with traumatic injury in the esthetic zone is complex. For the present patient, an intraoral scanner, a facial scanner, a jaw motion analyzer, and cone beam computed tomography were applied to collect patient data and establish a virtual dental patient. The virtual technology increased the accuracy of tooth- and implant-supported crowns in both appearance and occlusion.

A technique to convert a 3D printed cast used in the fabrication of an interim implant-supported crown into a definitive cast capturing the acquired emergence profile

An esthetic peri-implant soft tissue contour is a critical element of the success of implant restorations in the esthetic zone. Once the optimal transmucosal soft tissue profile is formed, it needs to be accurately replicated on the master cast. This clinical technique involves the utilization of a silicone putty positioning index placed in the patient's mouth to accurately duplicate the external contour of teeth and soft tissue. By combining this positioning index with the implant-supported interim crown, the 3D-printed initial cast, which was used to fabricate the interim crown, can be conveniently and efficiently transformed into a definitive master cast.