Virtual Articulator Research Articles

Evaluating sagittal condylar inclination: a comparative analysis of various digital workflow measures.

This study aims to compare sagittal condylar inclination (SCI) measurements derived from three workflows: intraoral scan (IOS) aligned with cone-beam computed tomography (CBCT), IOS aligned with facial scan (FS), and a jaw motion analyzer (JMA) system, in a cohort of young individuals with established normal occlusion. Additionally, the study aims to identify sources contributing to variance in these measurement approaches. Twenty-four healthy individuals exhibiting normal occlusion were enrolled in this clinical trial. The SCI was delineated using a virtual articulator (VA) by aligning IOS with both CBCT and FS, creating two distinct workflows labeled CBCT-IOS and FS-IOS, respectively. Concurrently, SCI measurements were also acquired using a JMA. The normality of data distribution for the difference in bilateral SCI measurements within each workflow was tested using the Shapiro-Wilk test. Depending on the outcomes of this test, we utilized either a paired-sample T-test or Wilcoxon test for bilateral SCI comparisons. The inter-workflow differences were assessed using the Kruskal-Wallis H test. Bland-Altman plots were assess the interchangeability and consistency across each pair of digital methods and to evaluate the aggregate consistency among the trio of digital approaches. The analysis revealed that the CBCT-IOS workflow yielded the lowest average SCI measurements, whereas the JMA workflow produced the highest values. No significant differences were found in the SCI measurements between the left and right sides obtained by CBCT-IOS and JMA (P > .05), with the exception of the FS-IOS workflow (P = .002). Additionally, inter-flow comparisons revealed no significant differences in SCI measurements (P > .05), except when contrasting the SCI as measured by CBCT-IOS and JMA (P = .0131). The Bland-Altman plots demonstrated a high degree of consistency and 95% limits of agreement across the three digital workflows. SCI measurements obtained from the three digital workflows exhibit a high degree of consistency and are interchangeable, affirming their clinical applicability for precise SCI assessment in young individuals with normal occlusion.

Computer-Assisted Porcelain Laminate Veneer Preparation: A Scoping Review of Stereolithographic Template Design and Fabrication Workflows.

Computer-assisted preparation of porcelain laminate veneers (PLVs) using stereolithographic templates has been developed to enhance the accuracy of tooth preparation. However, the digital workflows involved in guided PLV preparation remain inconsistently defined across various practices. Therefore, this scoping review aimed to examine publications on computer-assisted PLV preparation to identify the key stage of digital workflows involved in designing and fabricating stereolithographic templates, as well as to highlight the limitations of various template designs. This scoping review aimed to identify publications on digital workflows for designing and fabricating stereolithographic templates in computer-assisted porcelain laminate veneer preparation. A systematic search on MEDLINE/PubMed, Web of Science and Scopus identified English-language articles published from 2014 to March 2024. Eligible articles focused on digitally designed and fabricated tooth reduction templates for porcelain laminate veneers, excluding conventional tooth preparation procedures for tooth reduction assessment. Seven clinical reports were included, demonstrating various 3D data acquisition techniques for virtual patient generation. All articles described virtual diagnostic wax-ups on digital casts, with two using a virtual articulator. Only five articles documented chair-side mock-ups with resin trial restorations to evaluate planned dental esthetics. Additionally, virtual tooth preparation prior to templates design was included in only four articles. The templates were designed using different software and ranged from simple designs with access windows to complex stacked templates with rotary instrument sleeved windows. Each template design had limitations affecting tooth reduction accuracy. All articles reported printing templates in clear acrylic resin using different technologies. In conclusion, the review highlights a lack of standardization in the digital workflow for designing stereolithographic templates for PLVs. Establishing a sound protocol for designing the tooth reduction templates is essential to ensure the accuracy and consistency of veneer preparation.

Digital-assisted multidisciplinary treatment for complex occlusal rehabilitation: an 18-month follow-up case report

BackgroundThis case report highlights the importance of standardized and fully digital sequential treatment in complex occlusal rehabilitation cases. To fully resolve the patient’s dental needs, such cases often require multidisciplinary interventions including periodontal therapy, endodontic treatment, anterior esthetics, implant restoration, and prosthetic rehabilitation. A fully digital workflow (including facial scanners, intraoral scanners, jaw motion tracking systems, virtual articulators, and computer-aided design software) streamlined the complex treatment, enhancing workflow simplicity, efficiency, visibility, and precision.Case presentationThe patient presented with decreased chewing efficiency of the upper and lower prostheses, along with unsatisfactory esthetic appearance of the anterior teeth. After physical examination and radiological assessment, this complex occlusal rehabilitation case required periodontal therapy, anterior esthetic enhancement, implant restoration, and fixed prosthetic rehabilitation. Therefore, a fully digital workflow was adopted. Full-crown prostheses were placed on teeth 13, 23, and 34; a fixed bridge encompassed positions 32 to 42, and single implant crowns were placed on teeth 35 and 36. Implant-supported fixed bridges were constructed for teeth 12 to 22 and 44 to 46, anchored by implants at teeth 12, 22, 44, and 46. All definitive prostheses were fabricated from zirconia ceramics, chosen for their durability and esthetic characteristics. Finally, restorations with satisfactory esthetic and functional characteristics were seated, preserving the tooth and its supporting structures. During treatment and follow-up, the T-scan occlusal analysis system was utilized to continuously monitor and guide the adjustment of occlusal distribution across the patient’s dental arches. After 18 months, the patient remains satisfied with the definitive restorations.ConclusionsThis report is intended to help dentists understand and implement standardized and fully digital workflows during the management of complex occlusal rehabilitation cases; it may also facilitate harmonious integration of esthetic and functional characteristics.

Intraoral scanner-based virtual facebow transferring: A chairside dental technique.

Accurately mounting dental casts on an articulator is an essential step in prosthetic treatments. In digital dentistry, virtual articulator mounting procedures rely on virtual facebow records. However, virtual facebow records usually require devices like face scanners or jaw motion tracking systems that are not commonly available in most dental practices. The present technique report describes a straightforward intraoral scanner-based virtual facebow transfer approach. In this technique, a reference facebow joint support was first scanned and aligned with a virtual articulator. Then, a patient's facebow joint support and bite fork assembly were scanned chairside with an intraoral scanner and aligned with the virtual articulator by matching common features with the reference facebow joint support. After aligning the patient's intraoral scans with the patient's bite fork scan that was already superimposed on the virtual articulator, a virtual mounting process was achieved. Once the corresponding reference facebow joint supports have been generated, this technique can be easily implemented with most facebow systems and be seamlessly integrated into daily clinical practice as only an intraoral scanner and a conventional facebow were required.

Assessment of articulation parameters settings repeatability in Avantis 3D software

BACKGROUND: The three-dimensional (3D) space of a virtual articulator requires precise adjustment considering individual parameters for the precision work of orthopedic dentists, orthodontists, and dental technicians. A modern solution that includes a virtual articulator is the domestic Avantis 3D software, which simplifies and speeds up functional diagnostics by creating a 3D scene of the patient. AIM: To compare a repeatability of articulation parameters obtained when adjusting the domestic virtual articulator Avantis 3D using laboratory and intraoral scans of terminal positions of the lower jaw. MATERIALS AND METHODS: A group of 30 volunteers aged 18–35 years participated in this study. The group consisted of 18 women and 12 men. Each participant underwent a computed tomography of the maxillofacial region, including the temporomandibular joint region in a state of habitual occlusion; one-stage A-silicone impressions were obtained, plaster models were cast, and silicone bite registers of three terminal positions were made. An intraoral scan of the upper and lower jaws was performed, and optical bite scans were obtained in the position of maximum fissure-tubercle contact and in the terminal positions of the lower jaw, fixed by previously obtained silicone registers. The same protocol was conducted for plaster models of the patient’s dentition and silicone registers of terminal positions. Using intraoral scans, optical recorders of terminal positions and computer tomograms in the Avantis 3D program and 3D scenes were created, and a virtual articulator was configured. For each patient, the virtual articulator was adjusted in the Avantis 3D software, seven times using data from the intraoral scanner level and seven times from the laboratory level. The reproducibility of articulatory parameters was assessed for all types of scans obtained, examining the standard and individual intercondylar distances for each patient. RESULTS: The average values of the standard square deviation of articulatory parameters obtained when creating 3D scenes using laboratory scans at individual and standard intercondylar distances were higher than the similar values obtained using intraoral scans. CONCLUSION: The accuracy of creating a virtual copy of a patient can be influenced by several factors: the error in combining scans, repeated scanning, the error in combining scans and computer tomograms, the error in combining jaw and bite scans, and the presence of penetrating occlusal contacts between scans of the dentition.

A novel algorithmic approach for automatic virtual articulation to avoid dynamic interferences in dental restoration designs.

There is an ongoing debate about the benefits of the facebow and individual articulator settings in prosthodontics when compared with simpler methods. The present study aims to determine whether the implementation of novel algorithmic articulator concepts may be an alternative to avoid dynamic interference contacts during the design process of fixed posterior restorations, and to what extent the occlusal morphology of the restoration is affected. From a chairside CAD database, a total of 50 clinical patient cases documenting 61 planned fixed restorations in the posterior tooth region were selected. A common CAD software program was used for the automated knowledge-based design process. When designing the restorations, functional concepts were applied, including the pure static occlusion, the average articulation, three different articulator settings as a control, and a combination of a broad range of articulation parameters (the full range dynamic articulation). The resulting dynamic contact points were compared both visually and metrically with a monitoring software program. There is a highly significant difference in avoiding dynamic interference contacts when applying the full range dynamic articulation compared with the pure static occlusion (P < 0.001) and the average articulation (P < 0.001). Furthermore, the superimposition revealed that the surface of the restorations showed nearly no visual morphologic changes after virtually grinding-in the interpenetrating contact points. The full range dynamic articulation can be used for the design of small fixed posterior restorations to avoid most dynamic interference contacts without the need for determining individual parameters for each patient.

An overview of the different digital facebow methods for transferring the maxillary cast into the virtual articulator.

The purposes of this study were to classify the described digital facebow techniques for transferring the maxillary cast into the semi-adjustable virtual articulator based on the digital data acquisition technology used and to review the reported accuracy values of the different digital facebow methods described. Digital data acquisition technologies, including digital photographs, facial scanners, cone beam computed tomography (CBCT) imaging, and jaw tracking systems, can be used to transfer the maxillary cast into the virtual articulator. The reported techniques are reviewed, as well as the reported accuracy values of the different digital facebow methods. Digital photographs can be used to transfer the maxillary cast into the virtual articulator using the true horizontal reference plane, but limited studies have assessed the accuracy of this method. Facial scanning and CBCT techniques can be used to transfer the maxillary cast into the virtual articulator, in which the most frequently selected references planes are the Frankfort horizontal, axis orbital, and true horizontal planes. Studies analyzing the accuracy of the maxillary cast transfer by using facial scanning and CBCT techniques are restricted. Lastly, optical jaw trackers can be selected for transferring the maxillary cast into the virtual articulator by using the axis orbital or true horizontal planes, yet the accuracy of these systems is unknown. Digital data acquisition technologies, including digital photographs, facial scanning methods, CBCTs, and optical jaw tracking systems, can be used to transfer the maxillary cast into the virtual articulator. Studies are needed to assess the accuracy of these digital data acquisition technologies for transferring the maxillary cast into the virtual articulator.

A newly proposed classification for articulators-integrating virtual with conventional

A new and simple articulator classification has been proposed which includes both mechanical and virtual articulators to meet with the modern day dental practice that has shown a gradual shift toward digital technology and workflow.

Accuracy of Occlusal Contacts of All-Ceramic Single Crowns Designed by Virtual Articulators from a CAD/CAM System: A Preliminary Evaluation.

To compare the static and dynamic occlusion of all-ceramic single crowns designed by mechanical and virtual articulators, by evalua6ng the accuracy of occlusal contacts of prostheses designed by virtual articulators and the feasibility of clinical application of CAD/CAM virtual articulators. Nine subjects with an average age of 27 years who needed crown repair were recruited. After preparation of the all-ceramic crowns, two zirconia crowns were designed and fabricated through digital procedures and traditional methods. The intraoral scanner, Geomagic software, and T-Scan analyzer were used to analyze the occlusal contact points, areas, and the occlusal force percentage peak before the treatment and after the two crowns were temporarily fixed. There was a significant difference in the number of occlusal contact points and areas between the mechanical group and control group (preoperation group), but there was no obvious difference between the virtual group and control group. The occlusal contact overlapping areas of the virtual-control group were significantly larger than those of the mechanical-control group. The occlusal force percentage peak of the tested teeth was slightly larger in the mechanical group than in the virtual group. The posterior single crown designed by a virtual articulator restored the intercuspal occlusal better than one designed by a mechanical articulator, and it produced less dynamic occlusal interference. This finding suggests that virtual articulators can provide guidance for the design and adjustment of the occlusal surface of posterior single crown prostheses.

A Comprehensive Review on Virtual Articulators.

The virtual articulator (VA) is a technology that simulates the jaw relation in a computer-generated setting. Augmented and virtual reality have been utilized as digital technology, which aids in many areas of dentistry and dental education. Today, a practicing dentist must keep up with the newer technologies, but with technology evolving so quickly it becomes challenging. In dentistry, the possibilities for digitization and technological advancements are limitless.Virtual articulators (VAs) allow a complete occlusion analysis using dental models that replicate all mandibular motions in static and dynamic scenarios. VAwhen executed in addition to other software enhances treatment planning and patient education, allowing quicker and more precise individualized diagnoses. The main objective of this study was to describe and evaluate the study outcomes in the available research on VAs, assess their needs, and evaluate their advantages and limitations in various aspects. A PubMed Centralsearch was made of dental journals, with the identification of 135 articlesout of which 30 were finally selected. The investigations conducted to evaluate the VA's dependability provide good visualization of the quantity and location of the dynamic interactions. A precise instrument for fully analyzing occlusion in a real patient is the virtual articulator.

Comparison of three-dimensional position of maxillary dentition model treated with two digital transfer methods

Objective: To compare and evaluate the difference in maxillary dentition position using an anatomical facebow and jaw movement analyzer. Methods: From March to May 2023, 15 medical interns from Yantai Stomatological Hospital were recruited, including 9 males and 6 females, aged 20-25 years. Digital models and plaster models of maxillary dentition were obtained from the 15 medical interns. The anatomical facebow group (AFB) and jaw movement analyzer group (JMA) were used to transfer the position of the maxillary dentition to the virtual articulator. The virtual occlusal articulator module of exocad denture design software was used to measure the inclination angle of the occlusal plane of the two groups, the distance between the mesio-incisal angle of the left maxillary central incisor and the lateral center point of the lateral condylar sphere of the virtual occlusal articulator, the distance between the mesial buccal cusp of the maxillary first molar and the lateral center point of the lateral condyle sphere of the virtual articulator. The same marks (mesial incisor point of left maxillary central incisor and mesial buccal cusp point of both maxillary first molars) were measured in two groups of maxillary dentition, and the root-mean-square error between 3 points was calculated. Results: The occlusal plane inclination angle in AFB group (9.11°±3.85°) was significantly larger than that in JMA group (4.94°±2.69°) (t=10.45, P<0.001). There were significant differences between AFB and JMA groups. The distances from the mesial cusp of the left first molar to the lateral center of the left condylar, from the mesial cusp of the left maxillary central incisor to the lateral center of the left condylar[(91.75±3.05), (129.09±4.60) mm]were significantly smaller than those in the JMA group[(95.68±5.45), (132.41±5.64) mm](t=-4.48, P=0.001; t=-4.21, P=0.001). In both groups of models, the distance of the mesial cusp of the left maxillary central incisor was (8.81±2.56) mm, and the distance between mesial buccal cusp of maxillary left first molar was (7.56±2.49) mm, the distance between mesial buccal cusp of maxillary right first molar was (7.13±2.77) mm; the root mean square error was (7.93± 2.94) mm. Compared with 0, the difference was statistically significant (t=10.45, P<0.001). Conclusions: There were differences between the two methods (anatomical facebow and the jaw movement analyzer) for transferring the maxillary dentition position to the three-dimensional space position of the virtual articulator.

Is dynamic occlusal design necessary for anterior guidance recovery in the computer-aided design process? An in vitro study

ObjectivesThis study aimed to assess the effectiveness of patient-specific motion in restoring anterior guidance and to investigate the influence of occlusal plane position within a virtual articulator on the design of the anterior guide slope for incisors. MethodsTwenty participants' intraoral scan, occlusal plane position, and jaw motion data were recorded. The maxillary anterior teeth were virtually prepared, and the crowns were designed based on average virtual articulator (AVR), personalized virtual articulator (ART), and patient-specific motion (PSM). The anterior guide slope of maxillary central incisors (S1, S2, Sc, Sp) and the mesio-distal angle (MDA) of the canine of prostheses were compared to that of natural teeth (NAT). One-Way ANOVA was utilized to evaluate the effectiveness of the three methods in restoring the anterior guidance of maxillary anterior teeth. ResultsThe comparison of Sp and MDA showed no significant difference between the PSM and NAT groups (p > 0.05). However, Sp of the ART group was significantly smaller, while MDA was higher than that of the NAT group (p < 0.05). Sp did not differ significantly (p > 0.05) when the angle of the occlusal plane (AOP) was small. As the AOP increased, Sp of the ART and AVR groups were significantly smaller than that of the NAT group (p < 0.05). With a large AOP, Sp of the ART group was notably smaller than that of the NAT group (p < 0.05), while there was no significant difference between the AVR and NAT groups (p > 0.05). ConclusionsOcclusal design based on patient-specific motion proved more effective in restoring natural anterior guidance. The anterior guidance of prostheses designed using a virtual articulator was influenced by occlusal plane position. Clinical SignificanceThe utilization of a jaw motion tracer facilitated the transfer of personalized occlusal plane positions and recorded jaw motion, which can be integrated into the digital prosthetic workflow for virtual occlusion adjustment. Occlusal design based on patient-specific motion more effectively restored lingual guidance of maxillary anterior crowns.

The Role of Digital Facebow for CAD/CAM Implant-Supported Crowns Workflow.

Recent advancements in digital technologies have transformed clinical workflows in dentistry, ensuring precise restorations. Custom-made crowns and fixed partial dentures (FPDs) now rely on virtual articulation. The digital facebow provides individualized data for CAD settings, streamlining the fabrication via digital workflow. For the purpose of demonstrating the differences observed during fabrication, we present a case report involving a 68-year-old patient seeking a replacement for missing teeth 24, 25, 26, and 27. The treatment plan involved the fabrication of an implant-supported FPD using monolithic zirconia (ZrO2). However, technical hurdles emerged during the planning phase, primarily due to spatial limitations posing a risk of mechanical failure over time. Consequently, we pivoted approach towards a porcelain fused to metal (PFM) FPD. For the PFM FPD, individual values from the digital facebow adjusted both virtual and conventional articulators. For comparison, two ZrO2 FPDs were milled-individual settings and average settings. All restorations underwent assessment for occlusion in maximal intercuspal position and eccentric mandible movements. In conclusion, the case report showed that individualized PFM FPD required minimal adjustments compared to milled ZrO2 restorations, whether using individual or average values. Utilizing individual values from the digital facebow reduced operator working time and minimized the intraoral adjustments.

A case of improvement of esthetic and masticatory disorders using a virtual articulator

A case of improvement of esthetic and masticatory disorders using a virtual articulator

Recording maximal intercuspation and border positions of the mandible with intraoral scanner using the acquisition software's multi-occlusion function.

This in vitro study was conducted to investigate the accuracy of intraoral scanner (IOS) for recording maximal intercuspal position (MIP) and border positions of the mandible. Maxillary and mandibular master casts were articulated in MIP, protrusive, and lateral interocclusal position sequentially on a semi-adjustable articulator. For each articulation relation, sites of occlusal contacts (SOCs) and sites of clearance (SCs) were identified on the master casts with articulating paper (reference sites). IOS was used to take full arch scans and nine virtual interocclusal records (VIRs) for virtual articulation of models. Virtual SOCs and SCs were detected with 3D processing software and compared to those identified with the articulating paper. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated for each articulation relation. For MIP, IOS showed adequate sensitivity and NPV of 100%, and specificity and a PPV of 99%. For protrusive position, the IOS showed a sensitivity and a NPV of 100%, a high PPV of 86%, and a specificity of 83%. For lateral positions, the specificity and the PPV were high (93% and 79%, respectively), but the sensitivity and the NPV were below the clinically acceptable limits (28% and 56%, respectively). IOS displayed clinically acceptable accuracy for recording MIP and protrusive border mandibular position. However, IOS had less accuracy for lateral border mandibular position.

Digital application of three-dimensional diagnosis and treatment with a virtual articulator.

The purpose of this article was to introduce a method for the digital application of three-dimensional (3D) diagnosis and treatment with a virtual articulator and 3D data. With the use of cone-beam computed tomography (CBCT) and intraoral and facial scans, we can create a virtual articulator and evaluate the mandibular position in maximum intercuspation and centric-related occlusion for the patient with an unstable occlusion and temporomandibular disorders (TMD). Based on this, we treated a case using a digital mandibular position indicator (MPI) and fabricated a stabilization splint using a 3D printer. This approach eliminates the traditional impression or model mounting process and the analog face bow transfer. Furthermore, the design of the stabilization splint is accomplished using software. The approach outlined in this article offers the potential for a digital diagnosis and treatment process by seamlessly integrating CBCT, intraoral scans, and facial scans with a high degree of accuracy. This may enhance precision in diagnosis and treatment planning, especially for patients with complicated TMD, in addition to facilitating effective communication with orthodontic patients who require thorough attention. Utilizing a virtual articulator and digital MPI for the occlusal evaluation of patients with TMD and unstable occlusion makes it possible to diagnose and analyze the occlusal condition accurately. This approach also allows for precision and efficiency in treatment.

Application of 3D digital smile design based on virtual articulation analysis in esthetic dentistry: A technique

A technique for the application of a virtual articulation system in 3-dimensional digital smile design (DSD) during esthetic restoration is described. To acquire stable occlusion and a smooth jaw movement pattern without premature contacts or interference, a digital facebow and a virtual articulator were used to collect and analyze a patient’s occlusal data and jaw movement information. The original pattern of occlusal contacts and jaw movements were diagnosed as stable and copied to the digital design of the new prostheses. Preparation of the abutments, crown lengthening surgery, and definitive crown fabrication and cementation were performed according to the design. After 9 months, the occlusion remained stable, and the patient was satisfied with the outcome.

Occlusal instability: hybrid ceramic VITA ENAMIC in the virtual articulator.

Occlusal instability: hybrid ceramic VITA ENAMIC in the virtual articulator.

Virtual Dental Articulation Using Computed Tomography Data and Motion Tracking.

Dental articulation holds crucial and fundamental importance in the design of dental restorations and analysis of prosthetic or orthodontic occlusions. However, common traditional and digital articulators are difficult and cumbersome in use to effectively translate the dental cast model to the articulator workspace when using traditional facebows. In this study, we have developed a personalized virtual dental articulator that directly utilizes computed tomography (CT) data to mathematically model the complex jaw movement, providing a more efficient and accurate way of analyzing and designing dental restorations. By utilizing CT data, Frankfurt's horizontal plane was established for the mathematical modeling of virtual articulation, eliminating tedious facebow transfers. After capturing the patients' CT images and tracking their jaw movements prior to dental treatment, the jaw-tracking information was incorporated into the articulation mathematical model. The validation and analysis of the personalized articulation approach were conducted by comparing the jaw movement between simulation data (virtual articulator) and real measurement data. As a result, the proposed virtual articulator achieves two important functions. Firstly, it replaces the traditional facebow transfer process by transferring the digital dental model to the virtual articulator through the anatomical relationship derived from the cranial CT data. Secondly, the jaw movement trajectory provided by optical tracking was incorporated into the mathematical articulation model to create a personalized virtual articulation with a small Fréchet distance of 1.7 mm. This virtual articulator provides a valuable tool that enables dentists to obtain diagnostic information about the temporomandibular joint (TMJ) and configure personalized settings of occlusal analysis for patients.

Recommendations for successful virtual patient-assisted esthetic implant rehabilitation: A guide for optimal function and clinical efficiency.

Complete arch implant rehabilitation necessitates meticulous treatment planning and high-level collaboration between surgical and prosthetic dental teams. Emerging virtual technologies hold considerable promise in streamlining this process. The aim of this article is to extend recommendations to clinicians venturing into the virtual patient-assisted esthetic implant rehabilitation workflow. This article summarizes recommendations for virtual patient-assisted esthetic implant rehabilitation in the following five aspects: three-dimensional data handling and superimposition, occlusion and virtual articulator integration in creating virtual patients, streamlined face- and prosthetic-driven surgical planning, reuse of presurgical data ("Copy & Paste"), and final impression for passive fitting of final restoration. To illustrate these principles, a case with complete-mouth implant rehabilitation completed within six visits using this virtual patient workflow is presented. The virtual patient workflow serves as an invaluable tool to perform treatment planning, enhance efficiency, and ensure predictable outcomes in esthetic complete arch implant rehabilitation. Virtual workflows are increasingly prevalent in esthetic implant rehabilitation. Nevertheless, these workflows necessitate a distinct set of knowledge and tools divergent from conventional dentistry practices. This article offers guidelines and recommendations for dental clinicians who are new to this field.