Abstract
This paper describes the digital workflow from cone beam computer tomography (CBCT) to the installation of a definitive presurgical zirconium individual crown in a 19-year-old woman requiring implant replacement of a maxillary right lateral incisor. The patient had agenesis of this tooth and had completed the orthodontic treatment. CBCT was conducted and diagnostic casts were digitized. Virtual planning was completed by defining a prosthetically driven implant and a stereolithographic surgical template was produced. Good adaptation of a stereolithographic surgical template was verified in the working cast. Implant and abutment were installed in this cast using a stereolithographic surgical template, and a CAD/CAM definitive zirconium crown was produced. Flapless computer-guided implant surgery was performed. The abutment was connected, and a definitive zirconium crown was cemented using resin cement. The digital workflow presented herein shows high accuracy for a virtually planned implant with flapless guided placement, allowing the successful delivery of a definitive presurgical zirconium single crown in an esthetic area in a single visit. The patient was revaluated after 1 year of function with an excellent outcome of the treatment.
Highlights
Since the mid-1960s, when Branemark and colleagues described osseointegration [1], extensive research has been conducted to evaluate the long-term outcomes of dental implants [2]
Dental implants have considerably improved the rehabilitation of edentulous patients
Dental implantology has emphasized nature-like tooth replacement, minimally invasive surgical and restorative techniques, as well as time and cost efficiency [3]
Summary
Since the mid-1960s, when Branemark and colleagues described osseointegration [1], extensive research has been conducted to evaluate the long-term outcomes of dental implants [2]. Cone beam computer tomography (CBCT), as a threedimensional (3D) imaging tool in combination with implant planning software, facilitated the virtual implant planning defined by prosthetic and anatomical structural parameters [4,5,6] From this virtual implant planning, a custom static fit-template with drill guides is produced, resulting in precision transferring of virtual planned implant positioning to the patient, which facilitates the placement of the prosthesis at the end of surgery. A recent systematic review and meta-analysis of computer technology applications in surgical implant dentistry revealed a high implant survival rate (97.3%) and total mean error of 1.12 mm at the entry and 1.39 mm at the apex compared to virtually planned implant positioning [6] From this perspective, transferring 3D virtual planning in order to achieve accurate precision of flapless implant placement and a presurgical prosthetic reconstruction with an immediate implant loading are still challenging procedures. This clinical report demonstrates a digital workflow from a CBCT until the installation of a definitive presurgical zirconium individual crown
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