Digital Implantology full mouth reconstruction by complete 3D virtual workflow

Abstract

The present case report demonstrates a fully integrated digital protocol for pretreatment surgical & restorative implant planning and execution of a hopeless dentition. A 56-year-old female patient presented with a periodontally compromised failing dentition. Preclinical Protocol Aesthetic analysis was done in EXOCAD using DSLR photographs and a face scan (DOF). Further to that IOS (3shape Trios) STL file & CBCT Dicom file were integrated into the EXOPLAN software for virtual implant planning. A fully guided surgical stent was printed on the 3D printer (BEGO) and PMMA temporaries were milled for immediate loading. Clinical Protocol: Following full mouth extraction the surgical guide was placed with fixation pins. Seven active implants in the upper jaw & six in the lower jaw were placed and subsequently loaded with milled PMMA temporaries using multi-unit abutments. Upon healing, after 4 months intraoral scanning was done using a multi-unit scan body; function was restored using a customized milled titanium bar with Zirconia framework. We observed advantages such as simplification of clinical steps with accurate reproduction of proposed planning done prior with complete digital workflow. The entire process provided us extreme precision in delivering the temporary and final prosthesis as planned prior to the surgery. The patient was extremely satisfied with the treatment and the situation remained stable at follow-up. Fully digital implant workflow is restoratively driven and provides predictable aesthetic and functional treatment outcomes. The procedure requires additional training for the implantologist and has a learning curve.