Using the surgical guide for impression-free digital bite registration in the edentulous maxilla\u2014a technical note

George Michelinakis,Dimitrios Nikolidakis

doi:10.1186/s40729-019-0172-8

Abstract

Studies reporting on the application of digital bite registration for fully edentulous patients rehabilitated with dental implants are scarce. This article describes a technique for intraoral digital registration of the occlusal vertical dimension in a fully edentulous maxilla to be rehabilitated with a fixed implant prosthesis. Following fully guided placement of six maxillary implants, the surgical stent duplicating the existing upper full denture was securely fixed on two anterior implants and sectioned along the center line of the hard palate. An intraoral scanner was used for the digital impression of the maxilla and dentate mandible. The occlusal vertical dimension was registered on each side using the contralateral part of the surgical guide along with the scanbodies on each side. The procedure allowed for the precise digital mounting of the digitized jaws. The maxilla was restored with a full-arch implant-supported prosthesis.

Highlights

Accurate impression making is a cornerstone for well-fitting tooth and implant-supported restorations
The accuracy of digital impressions produced with an intraoral scanner has been studied extensively, both for single teeth and short span distances [4,5,6,7] as well as long span distances [8,9,10,11,12] with very favorable results compared to the accuracy of conventional impression workflows [13]
In the case presented, six endo-osseous implants were installed in the fully edentulous maxilla using a flapless approach with a pilot-guided surgical stent and the patient was restored with an implant-supported fixed prosthesis in a semi-digital approach

Summary

Introduction

Accurate impression making is a cornerstone for well-fitting tooth and implant-supported restorations. The introduction of intraoral scanning (IOS) in recent years has allowed dentists to acquire data directly from the mouth of the patients without the need for a conventional impression material and technique [2, 3]. Literature suggests that the Another challenge in restoring these patients, either with complete removable or with implant-supported fixed prostheses, is the precise digital registration of the moveable soft tissues [18] and the precise digital registration of the vertical dimension of occlusion [19]. Capturing the bite at the correct occlusal vertical dimension (OVD) with the aid of full-arch fixed implant-retained interim prosthesis as a guide has been previously reported in the literature [20, 21].

Objectives

Discussion

Conclusion