3D-Printed Overlay Template for Diagnosis and Planning Complete Arch Implant Prostheses

Evaluation of Glazing and Polishing for Novel Chairside CAD/CAM Lithium Disilicate Containing Virgilite Crystals

This comparative in vitro study evaluated surface treatment methods for chairside CAD/CAM lithium disilicate enriched with virgilite using atomic force microscopy (AFM) imaging. Specimens were fabricated from two lithium disilicate materials: the traditional material (IPS e.max CAD, Ivoclar Vivadent, Schaan, Liechtenstein) and a virgilite-containing material (CEREC Tessera, Dentsply Sirona, Charlotte, NC, USA). Surface roughness (Ra) [in micrometers (μm)] was quantitatively assessed with AFM. The results demonstrated that IPS e.max CAD with glazing exhibited the smoothest surface with the lowest Ra values (10.03 ± 5.03 μm). In contrast, CEREC Tessera exhibited the highest surface roughness when treated with glazing (51.98 ± 12.31 μm), while the zirconia polishing system provided a smoother surface (15.44 ± 9.69 μm).

Immediate Implant Therapy with Full-Digital Workflow to Replace a Central Incisor

Background: Replacing a maxillary central incisor and immediately placing an implant represents a clinical challenge. Methods: This case report demonstrates a full digital workflow to achieve a predictable implant placement and esthetically pleasing restoration for a 35-year-old male patient who suffered a horizontal root fracture after a sports accident. The patient's treatment included digital implant planning, minimally traumatic tooth extraction, computer-guided implant placement, soft tissue augmentation, and a provisional restoration to contour the augmented gingival tissues. The process began with cone beam computed tomography (CBCT) evaluation and patient consultation on treatment options, with the patient opting for implant therapy. Using a 3D-printed surgical guide, the implant was placed precisely, and a soft tissue graft was used to enhance the gingival architecture and volume. A provisional restoration was designed to support the emergence profile and condition the peri implant soft tissues. A final digital impression was made, and a screw-retained all-ceramic crown was fabricated uneventfully after healing. Results: This digital approach allowed accurate planning and allowed the efficient execution of a technique-sensitive procedure such as immediate implant placement, thus providing an esthetic and functional solution while minimizing treatment time. Conclusions: The case highlights that immediate implant therapy in the esthetic zone requires meticulous planning and execution, and that incorporating advanced digital tools and techniques is required to achieve favorable clinical outcomes.

Occlusion and Biomechanical Risk Factors in Implant-Supported Full-Arch Fixed Dental Prostheses-Narrative Review

The biophysiological differences between teeth and dental implants and the issue of occlusal overload, although controversial, form the basis for the management of occlusion in implant-supported full-arch fixed dental prostheses (ISFAFDPs). Although there is currently a lack of scientific evidence on occlusal management, it is clear that the favorable prognosis of ISFAFDPs is linked to a correct understanding of the biomechanical principles involved. In the design of ISFAFDPs, the lack of proprioceptive feedback requires special attention to biomechanical factors: minimizing overloading complications and providing biomechanical stability are among the main goals of the occlusion. In ISFAFDPs, the occlusion must be decided on the basis of several factors that influence the loads on prosthesis and implants: each case must be evaluated individually and requires a personalized occlusion. The main aim of this narrative review is to provide an overview of the occlusal principles and materials that can be used in ISFAFDPs based on the data currently available in the literature. Practical clinical recommendations for the occlusion management of ISFAFDPs and a biomechanical risk score index to personalize implant-prosthetic treatment are proposed.

3D-printed shell complete dentures as a diagnostic aid for implant planning and fabricating interim restorations for complete arch rehabilitations: A case series

3D-printed shell complete dentures generated from a scan of the patient's existing prostheses can simplify and expedite the surgical planning and interim restoration design for complete arch rehabilitations. Three patients were rehabilitated with endosteal implants, and interim restorations were generated from the contours of the 3D-printed shell complete dentures used as diagnostic aids. This case series report presents the recommended protocol and its clinical progression, in addition to clinical and radiographic images of the treatment outcomes.

Combining Orthodontic and Restorative Care with Novel Workflows

This report describes multidisciplinary care combining orthodontics and restorative dentistry for a patient with Class II occlusion and stained mandibular and maxillary resin composite veneers. The orthodontic treatment improved severe overjet and malocclusion prior to restorative care. Occlusal assessment was provided with a novel digital device (PlaneSystem, Zirkonzahn) that is integrated with digital workflows for the evaluation of the occlusal plane and condylar path inclination. Diagnostic digital impressions and digital wax-up for intraoral mock-ups led to the patient's treatment acceptance. Minimally invasive tooth preparation, final digital impressions, and bonding under dental dam isolation fulfilled the patient's esthetic and functional demands with all-ceramic restorations.

The 3D-printed shell complete denture technique: Simplifying prosthodontic diagnosis prior to implant planning

Traditionally, artificial teeth arrangements or the definitive complete dentures are used to establish important prosthodontic parameters such as the occlusal plane orientation, vertical dimension, and the incisal edge position. The relationship of these elements with the underlying bony structures is commonly evaluated using advanced planning protocols such as the dual scan technique. This technique article presents an uncomplicated alternative approach to establish these parameters intraorally using a 3D-printed shell complete denture generated from a 3D scan of the patient's existing complete denture.

Expediting the Rehabilitation of Severely Resorbed Ridges Using a Combination of CAD-CAM and Analog Techniques: A Case Report

With the life expectancy increasing, there is a growing need for prosthetic dental treatments to restore the oral health, function, and quality of life of edentulous patients. Presently, only a few articles are available describing the oral rehabilitation of patients with severely resorbed ridges with milled complete dentures. This clinical case report provides a straightforward protocol consisting of a combination of analog and digital techniques for the rehabilitation of edentulous patients with severely resorbed ridges with milled fixed and removable complete dentures. This technique permits the minimization of the number of appointments, improves patient comfort, allows for the digital archiving of important clinical data, and permits the manufacture of prostheses with improved mechanical properties. These favorable outcomes were achieved by using the patient's existing PMMA complete denture as a custom tray for a final impression with light-bodied Polyvinylsiloxane. Subsequently, the resulting models were digitized, and a digital complete denture was designed and manufactured in an expedited manner using CAD-CAM techniques. Therefore, this case report highlights the potential of CAD/CAM technology to predictably restabilize oral functions and improve patients' quality of life.

A Retrospect of the Special Issue "Second Edition of Innovative Solutions for Oral Healthcare"

Medicine and oral health are constantly progressing through a series of small advancements that, together, lead to significant discoveries and breakthroughs [...].

Conventional and Digital Impressions for Fabrication of Complete Implant-Supported Bars: A Comparative In Vitro Study

Obtaining accurate models and well-fitting prostheses during the fabrication of complete implant-supported prostheses has been a significant challenge. Conventional impression methods involve multiple clinical and laboratory steps that can lead to distortions, potentially resulting in inaccurate prostheses. In contrast, digital impressions may eliminate some of these steps, leading to better-fitting prostheses. Therefore, it is important to compare conventional and digital impressions for producing implant-supported prostheses. This study aimed to compare the quality of digital intraoral and conventional impressions by measuring the vertical misfit of implant-supported complete bars obtained using both types of techniques. Five digital impressions using an intraoral scanner and five impressions using elastomer were made in a four-implant master model. The plaster models produced with conventional impressions were scanned in a laboratory scanner to obtain virtual models. Screw-retained bars (n = five) were designed on the models and milled in zirconia. The bars fabricated using digital (DI) and conventional (CI) impressions were screwed to the master model, initially with one screw (DI1 and CI1) and later with four screws (DI4 and CI4), and were analyzed under a SEM to measure the misfit. ANOVA was used to compare the results (p < 0.05). There were no statistically significant differences in the misfit between the bars fabricated using digital and conventional impressions when screwed with one (DI1 = 94.45 µm vs. CI1 = 101.90 µm: F = 0.096; p = 0.761) or four screws (DI4 = 59.43 µm vs. CI4 = 75.62 µm: F = 2.655; p = 0.139). Further, there were no differences when the bars were compared within the same group screwed with one or four screws (DI1 = 94.45 µm vs. DI4 = 59.43 µm: F = 2.926; p = 0.123; CI1 = 101.90 µm vs. CI4 = 75.62 µm: F = 0.013; p = 0.907). It was concluded that both impression techniques produced bars with a satisfactory fit, regardless of whether they were screwed with one or four screws.