Immediate restorations in a fully edentulous patient utilizing digital system: A case report

Jeong-Whan Fang; Seung-Mi Jeong; Se-Ha Kang; Chan-Hyeon Hwang; Dae-Hwan Kim; Byung-Ho Choi

doi:10.4047/jkap.2015.53.2.157

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Fang, Jeong, Kang, Hwang, Kim, and Choi: Immediate restorations in a fully edentulous patient utilizing digital system: A case report

Case Report

J Korean Acad Prosthodont 2015;53(2):157-166.

Published online: 9 February 2015

DOI: https://doi.org/10.4047/jkap.2015.53.2.157

Immediate restorations in a fully edentulous patient utilizing digital system: A case report

Jeong-Whan Fang¹, Seung-Mi Jeong^1,^∗, Se-Ha Kang¹, Chan-Hyeon Hwang¹, Dae-Hwan Kim¹, Byung-Ho Choi²

¹Department of Prosthodontics, Wonju College of Medicine, Yonsei University, Wonju, Republic of Korea

²Department of Oral and Maxillofacial Surgery, Wonju College of Medicine, Yonsei University, Wonju, Republic of Korea

^∗Corresponding Author: Seung-Mi Jeong Department of Prosthodontics, Wonju College of Medicine, Yonsei University, 20 Iisan-ro, Wonju 220-701, Republic of Korea +82 33 741 2114: e-mail, smj3@yonsei.ac.kr

^※ This work was supported in part by Yonsei University Research Grant of 2008 (YUWCM-2008-25).

Received 23 February 201527 March 2015 Accepted 3 April 2015

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

This article describes how to use CBCT and an intraoral scanner in a fully edentulous case that enables the clinician to place implants with flapless guided surgery and to engage prefabricated, customized implant abutments at the time of implant surgery, with only 1 clinical consultation before implant surgery. The patient's existing denture is used to simulate the teeth, the soft tissue and the vertical dimension of occlusion, and jaw relationship in the fully edentulous jaw. It provides clinicians with a fast workflow and improves clinical efficiency.

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Keywords: Edentulous, Intraoral scan, Invert scan image, CAD/CAM, Flapless implant surgery

REFERENCES

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2. Di Giacomo GA, Cury PR, de Araujo NS, Sendyk WR, Sendyk CL. Clinical application of stereolithographic surgical guides for implant placement: preliminary results. J Periodontol. 2005; 76:503–7.

3. Ruppin J, Popovic A, Strauss M, Spü ntrup E, Steiner A, Stoll C. Evaluation of the accuracy of three different computer-aided surgery systems in dental implantology: optical tracking vs. stereolithographic splint systems. Clin Oral Implants Res. 2008; 19:709–16.

4. Van Assche N, van Steenberghe D, Guerrero ME, Hirsch E, Schutyser F, Quirynen M, Jacobs R. Accuracy of implant placement based on pre-surgical planning of three-dimensional cone-beam images: a pilot study. J Clin Periodontol. 2007; 34:816–21.

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Fig. 1.

Pretreatment condition. (A) Frontal view, (B) Maxillary occlusal, (C) Mandibular occlusal, (D) Right posterior, (E) Left posterior.

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Fig. 2.

Marker for scanning and CBCT taking.

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Fig. 3.

Scanning of the denture, including the denture base, teeth and markers. (A) Scanning the denture base, (B) Scanning the marker and edge of denture base, (C) Scanning the denture teeth and marker.

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Fig. 4.

Patient wearing the denture with markers. (A) Patient wearing the denture and taking CBCT, (B) 3 markers bonded to the denture.

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Fig. 5.

Digital images of the denture and the opposing teeth with interocclusal relationship.

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Fig. 6.

Virtual process of deleting aspects of the denture image and inverted image of the denture base. (A) Deleting aspects of denture image by Shape Designer, (B) The inverted image of denture base.

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Fig. 7.

Intraoral image with vertical dimension of occlusion and jaw relationship.

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Fig. 8.

Image fusion of the inverted images from the intraoral scanner with images from the CBCT scan (Image matching of the inverted scan image and CBCT image).

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Fig. 9.

Implant planning. (A)Virtual tooth arrangement, (B) Implant planning, (C) After the implant planning, (D) Check implant position in the occlusial view.

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Fig. 10.

Surgical guide designed and printed. (A) The surgical guide designed by computer software, (B) The surgical guide fabricated by 3D printer.

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Fig. 11.

The designed provisional restoration in the frontal view (A) Customized abutments designed by computer software (B) Check the abutment and provisional restoration in occlusal view (C) Check occlusion with vitual articulator (D) Fabricated abutments and provisional restoration (E).

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