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Hamilton A, Griseto N, Negreiros WM, Gallucci GO. Digital articulation of a complete arch fixed implant prosthesis using the implant prosthetic connections: A dental technique. J Prosthet Dent 2024; 131:793-799. [PMID: 35431031 DOI: 10.1016/j.prosdent.2022.02.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 02/14/2022] [Accepted: 02/15/2022] [Indexed: 10/18/2022]
Abstract
A method for the digital articulation of complete arch digital implant scans using the implant abutment prosthetic interfaces is described. This technique provides an effective and efficient method for articulating digital scans without the need for matching soft tissue references or fiduciary markers. This allows for a streamlined workflow with fewer intraoral scans and can provide a precise replication of the intaglio surface and emergence profile of an existing restoration.
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Affiliation(s)
- Adam Hamilton
- Discipline Lead in Prosthodontics and Graduate Program Convenor, University of Western Australia Dental School, Nedlands, Western Australia, Australia; Lecturer, Division of Regenerative and Implant Sciences, Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Mass.
| | - Neil Griseto
- Interim Program Director of the Division of Regenerative and Implant Sciences, Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Mass
| | | | - German O Gallucci
- Associate Professor and Chairman, Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Mass
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2
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Chen D, Zhao W, Ren L, Tao K, Li M, Su B, Liu Y, Ban C, Wu Q. Digital PBL-CBL teaching method improves students' performance in learning complex implant cases in atrophic anterior maxilla. PeerJ 2023; 11:e16496. [PMID: 38077445 PMCID: PMC10710131 DOI: 10.7717/peerj.16496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 10/30/2023] [Indexed: 12/18/2023] Open
Abstract
Background The clinical teaching of esthetic implant-supported restoration of the atrophic maxilla is challenging due to the complexity and unpredictability of bone and soft tissue augmentation. The traditional problem-based learning and case-based learning method (PBL-CBL method) with a full digital workflow (digital PBL-CBL method) provides the students a chance to view clinical cases in a more accurate and measurable way. The aim is to evaluate the effectiveness of the new digital PBL-CBL method in teaching complex implant cases in esthetic area. Materials & Methods A full digital workflow of dental implant therapy was established for patients with severely atrophic anterior maxilla. The digital data of cases done in the new workflow was used as teaching materials in digital PBL-CBL teaching. Fifty-four postgraduate students were randomly selected and divided into three groups, including traditional PBL-CBL group (students taught in a PBL-CBL method with no digital cases), digital PBL-CBL group (students taught in a PBL-CBL method with full digital cases) and control group (students taught in didactic teacher-centered method). After training for three months, a study of the students' opinions on the corresponding teaching method was carried out through a feedback questionnaire. A theory test was used to evaluate students' mastery of knowledge about tissue augmentation and esthetic implant restoration. A case analysis was used to determine whether students could apply the knowledge to problem solving. Results The digital PBL-CBL method resulted in a higher rate of satisfaction than the traditional PBL-CBL method and the didactic teacher-centered method in all items except for "This approach decreases extracurricular work". Case analysis scores of the digital PBL-CBL group were significantly higher than that of the traditional PBL-CBL group and the control group. For the theory test, the digital PBL-CBL group (61.00 ± 6.80) but not traditional PBL-CBL group (55.22 ± 9.86) obtained a significant higher score than the control group (45.11 ± 12.76), although no significant difference was found between the digital PBL-CBL group and the traditional PBL-CBL group. Conclusion Compared with other methods, students taught with the digital PBL-CBL method showed higher satisfaction and better performance in acquisition of academic knowledge and ability in solving practical clinical problems. The digital PBL-CBL method provided a promising alternative for teaching complex implant cases at the anterior maxilla.
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Affiliation(s)
- Dan Chen
- Stomatological Hospital of Chongqing Medical University, Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Wenyan Zhao
- Stomatological Hospital of Chongqing Medical University, Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Li Ren
- Stomatological Hospital of Chongqing Medical University, Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Kunli Tao
- Stomatological Hospital of Chongqing Medical University, Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Miaomiao Li
- Dazhu Traditional Chinese Medicine Hospital, Chongqing, China
| | - Beiju Su
- Dazhu Traditional Chinese Medicine Hospital, Chongqing, China
| | - Yunfei Liu
- Stomatological Hospital of Chongqing Medical University, Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Chengzhe Ban
- Ruitai Stomatological Hospital, Chongqing, China
| | - Qingqing Wu
- Stomatological Hospital of Chongqing Medical University, Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
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3
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Sun J, Pu T, Ding Q, Xu H, Kang Y, Zhang L. Digital replication and transfer of interim to definitive complete arch implant-supported fixed prostheses by using a laboratory scanner. J Prosthet Dent 2023:S0022-3913(23)00361-X. [PMID: 37453885 DOI: 10.1016/j.prosdent.2023.05.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 05/02/2023] [Accepted: 05/03/2023] [Indexed: 07/18/2023]
Abstract
The present technique describes an effective digital approach for the replication and transfer of occlusion, maxillomandibular relationship, and esthetic parameters from interim to definitive complete arch implant-supported fixed prostheses by laboratory scanning with transfer plates. Monolithic zirconia complete arch implant prostheses have been fabricated with satisfactory functional and esthetic outcomes.
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Affiliation(s)
- Jiao Sun
- Graduate student, Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, PR China
| | - Tingting Pu
- Dental Technician, Denture Processing Center, Peking University School and Hospital of Stomatology, Beijing, PR China
| | - Qian Ding
- Resident, Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, PR China.
| | - Hong Xu
- Dental Technician, Denture Processing Center, Peking University School and Hospital of Stomatology, Beijing, PR China
| | - Yanfeng Kang
- MDS Graduate, Department of Prosthodontics and Center for Oral Functional Diagnosis, Treatment and Research, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, PR China
| | - Lei Zhang
- Professor, Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, PR China
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4
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Liu X, Zhou T, Gao H, Zhou J, Li D, Tan J. Three-point sectional-cast digital method for transferring the interocclusal relationship for full-mouth rehabilitation of worn dentition. J Prosthodont 2023; 32:273-277. [PMID: 36586420 DOI: 10.1111/jopr.13636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 12/19/2022] [Accepted: 12/20/2022] [Indexed: 01/02/2023] Open
Abstract
For full-mouth rehabilitation of worn dentition, "diagnostic" interim restorations are required to reestablish the interocclusal relationship. It is important but challenging to transfer the interocclusal relationship and to map the basic form and contour of interim restorations to the final restorations. Alignment of interim restorations and working casts is difficult when using digital workflows because of a lack of consistent hard tissue reference points. The digital workflow presented in this study used a "3-point sectional-cast digital cross-mounting method" to transfer the interocclusal relationship during full-mouth rehabilitation. An intermediate cast was made with three interim restorations: one on an incisor and two on molars. The interocclusal relationship and occlusal morphologies of the diagnostic interim prostheses were transferred and aligned to working casts using the 3-point sectional casts.
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Affiliation(s)
- Xiaoqiang Liu
- Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, P. R. China
| | - Ti Zhou
- Fushan Branch, Yantai Stomatology Hospital, Yantai, P. R. China
| | - Hanqi Gao
- Department of Second Dental Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, Shanghai, P. R. China
| | - Jianfeng Zhou
- Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, P. R. China
| | - Deli Li
- Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, P. R. China
| | - Jianguo Tan
- Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, P. R. China
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Sobczak B, Majewski P. An Integrated Fully Digital Prosthetic Workflow for the Immediate Full-Arch Restoration of Edentulous Patients-A Case Report. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074126. [PMID: 35409808 PMCID: PMC8998896 DOI: 10.3390/ijerph19074126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 03/23/2022] [Accepted: 03/28/2022] [Indexed: 11/16/2022]
Abstract
Digital prosthetic workflows may significantly increase the efficiency and predictability of the immediate rehabilitation of implant-supported fixed complete dentures. Advanced digital prosthetic workflows require exact and detailed virtual planning models. The direct generation of these models via direct digital impressions remains technique sensitive and demanding. This report illustrates an advanced digital workflow for accurate and efficient immediate full-arch restoration, with an aesthetically and anatomically adapted natural tooth-like prosthesis. The workflow application to fully edentulous arches, and arches with residual failing dentition, is presented. A key characteristic was efficiently integrating and interlinking the prosthetic and surgical workflows via denture replica surgical guides as landmarks for scan registration. This approach allowed for accurate implant placement and efficient and detailed anatomy-based chairside prosthetic planning, and for the manufacturing of the provisional and final restorations under detailed consideration of implant restoration, and the patient's macro-aesthetic and soft tissue anatomy.
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Affiliation(s)
- Barbara Sobczak
- Dr Sobczak Dental Clinic, 04-881 Warsaw, Poland
- Correspondence:
| | - Piotr Majewski
- Implant Dentistry Department, Dental Institute Collegium Medicum, Jagiellonian University, 31-155 Cracow, Poland;
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Marinis A, Papaspyridakos P, Sicilia E, Bernandes SR, Touloumi F, Chochlidakis K, Weber HP. Digital Workflow for Double Complete Arch Zirconia Prostheses Utilizing a Novel Scan Body. J Prosthodont 2021; 31:4-8. [PMID: 34453373 DOI: 10.1111/jopr.13417] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/23/2021] [Indexed: 12/01/2022] Open
Abstract
The purpose of this clinical report is to present a complete digital workflow for the fabrication of complete arch fixed zirconia implant restorations. An intraoral scanner was used to capture the implants' position at the abutment level and also the patient's existing interim prostheses with the double digital scanning technique. A novel scan body and impression pin were utilized throughout the scanning process which allowed for the accurate and reproducible superimposition of the generated Standard Tesselation Language (STL) files. Prosthesis prototypes were digitally designed and fabricated, tried in, and verified intraorally. The definitive zirconia prostheses were then fabricated and delivered to the patient. This technique can be utilized in both arches overcoming the absence of stable intraoral landmarks for superimposition of STL files.
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Affiliation(s)
| | - Panos Papaspyridakos
- Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, MA.,Department of Prosthodontics, University of Rochester Eastman Institute for Oral Health, Rochester, NY
| | - Elena Sicilia
- Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, MA
| | - Sergio Rocha Bernandes
- The Latin American Institute of Dental Research and Education, Head of New Product Development and Clinical Practice at Neodent, Curitiba, Brazil
| | - Foteini Touloumi
- Division of Prosthodontics, University of Connecticut Health Center, Farmington, CT
| | - Konstantinos Chochlidakis
- Department of Prosthodontics, University of Rochester Eastman Institute for Oral Health, Rochester, NY
| | - Hans-Peter Weber
- Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, MA.,Clear Choice Dental Implant Center, Quincy, MA
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Pozzi A, Hansson L, Carosi P, Arcuri L. Dynamic navigation guided surgery and prosthetics for immediate loading of complete-arch restoration. J ESTHET RESTOR DENT 2021; 33:224-236. [PMID: 33470044 DOI: 10.1111/jerd.12710] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 12/23/2020] [Accepted: 01/04/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To assess clinical and radiological performance of novel digital workflow integrating dynamic guided surgery, to streamline execution of implant placement, soft and bone tissue sculpturing, and immediate delivery of navigation guided complete-arch prosthesis. MATERIALS AND METHODS This proof of concept prospective single cohort study investigated 10 consecutive patients (three males, seven females; mean age 62.5 ± 8.9 years; range, 48-75) requiring at least one complete-arch fixed dental prostheses (FDP) in both jaws, treated between January and August 2019. Primary outcomes were implant and prosthetic success rates, surgical and prosthetic complications. Secondary outcomes were marginal bone loss (MBL), implant stability quotient (ISQ), periodontal parameters (plaque and bleeding indexes). RESULTS Sixty implants (32 NobelParallel TiUltra and 28 NobelActive TiUltra, Nobel Biocare) were placed and 14 complete-arch FDPs immediately loaded (mean follow-up 16.2 ± 1.7 months, 14-18). One implant failed and was immediately replaced. No other surgical or biological complications occurred, accounting for a cumulative success rate of 98.3%. No prosthetic complication occurred, leading to 100% prosthetic success rate. Mean ISQ at implant placement was 71 ± 2.8 (65-78). The mean MBL was -0.53 ± 0.28 mm (-0.22 to -1.12 mm). Plaque and bleeding scores were 14.4 ± 8.18 and 7.15 ± 4.4, respectively. CONCLUSION Within the limitations of this proof-of-concept dynamic navigation was effective to deliver in the planned coordinates both implants and prosthesis and guide bone and soft tissue sculpturing. Immediate loading of digitally prefabricated esthetically driven complete-arch FDP was facilitated, resulting in high implant and prosthetic success rates. CLINICAL SIGNIFICANCE The investigated digital workflow integrating dynamic navigation may overcome the difficulties related to immediate positioning and loading of digitally prefabricated complete-arch FDP. The navigation guided soft and bone tissues sculpturing, associated to xenogeneic collagen matrix grafting, represented a predictable technique to achieve the digitally planned interface, reestablishing the mucosal dimension required for the protection of underlying bone while maintaining tissue health.
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Affiliation(s)
- Alessandro Pozzi
- Goldstein Center for Esthetic and Implant Dentistry, Department of Restorative Sciences, Augusta University, Augusta, Georgia, USA.,International Center Oral rehabilitation, Rome, Italy
| | - Lars Hansson
- LH Dental Design Solutions, Virginia Beach, Virginia, USA
| | - Paolo Carosi
- Department of Chemical Science and Technologies, Materials for Health, Environment and Energy - Dentistry, University of Rome Tor Vergata, Rome, Italy
| | - Lorenzo Arcuri
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Rome, Italy
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