Integrating a Facially Driven Treatment Planning to the Digital Workflow for Rehabilitation of Edentulous Arches: A Case Report

Abstract

This case report presents the integration of a digital facially driven prosthetic plan to the computer-assisted implant planning for rehabilitation of edentulous arches. Diagnosis of edentulous arches is hampered by the lack of intraoral references. However, a digital facial profile analysis facilitates the treatment plan, taking into consideration the harmony among teeth, lips, and face to restore a pleasant smile. The first appointment consisted of digital documentation including intraoral scans, facial scans, and photographs. Based on these data, a smile frame was created to guide the digital wax-up. Cone-beam computed tomography (CBCT) scans were merged to facial and intraoral scans to perform the virtual surgical planning. Integration between facial, intraoral, and bone tissues were used as a reference to define implant position and prosthetic planning. The digital planning was integrated into the surgical procedure using stackable templates, and an immediate loading was performed. The interim prosthesis was manufactured based on the digital wax-up. With digital data, quality control could be performed to evaluate the esthetic outcome of the treatment. An esthetic and functional rehabilitation was possible using the respective digital workflow to define harmony between a smile and facial tissues. A digital treatment implant planning can be conducted considering patient's individual needs to improve the esthetic outcome.