Fabrication of a Dual-Purpose Implant Surgical Guide.

While surgical guides have allowed for more highly accurate immediate implant placement in the esthetic zone, only a few techniques have been described to predictably position an immediate implant provisional. Even fewer techniques have addressed repositioning a patient's extracted tooth for use as the interim implant restoration. This article describes a workflow for the fabrication of a dual-purpose surgical guide that allows for guidance of implant placement as well as repositioning of a decoronated tooth that will serve as a provisional. While other provisional techniques aim to recreate proper gingival contour, the benefit of repositioning of the original tooth is the preservation of the existing gingival margin position and existing critical contour of the emergence profile.

Implant position and guided placement for in-house-produced CAD/CAM restorations with titanium (Ti)-bases.

Digital dentistry has contributed to the evolution and simplification of dental implantology over the last decade. The incorporation of intraoral scanners, CBCT, 3D implant-planning software, and CAD/CAM systems makes prosthetically driven implantology a straightforward process. Such digital resources for treatment planning and execution, following evidence-based concepts, have the ability to improve the long-term esthetics and function of implant-supported restorations as well the long-term survival of dental implants. Dental implants are frequently considered as the first treatment option for replacing failing or missing teeth. However, their use in the esthetic zone remains a challenge for many clinicians. The present article provides clinical guidelines for ideal implant positioning employing computer-guided surgery and chairside CAD/CAM-fabricated provisional and definitive restorations with titanium (Ti)-bases for successful prosthetic outcomes, optimizing gingival architecture, and decreasing overall treatment duration. (Int J Comput Dent 2023;26(1):75-0; doi: 10.3290/j.ijcd.b3818287).

Digital Full-Mouth Reconstruction: From Diagnostics to Final Full Zirconia Restorations.

BACKGROUND: This clinical report describes the use of digital technology for full-mouth rehabilitation using fixed implant-supported full-contour zirconia prostheses. CASE PRESENTATION: A 61-year-old female patient presented with existing acrylic overdentures retained by mini implants; her chief concern was to improve esthetics and function through the use of fixed prostheses. Digital tools comprising CAD/CAM, 3D printing, guided implant surgery, and 2D smile design were utilized from the planning stage to final restorations combined with analog components in an efficient manner to address the patient's chief concern. Existing mini implants were used to help position surgical guides and provisional restorations. Final restorations were fabricated using a monolithic multilayered full-contour zirconia dental material, which provided excellent physical and esthetic properties. CONCLUSION: Digital technology is an essential component of modern dentistry to achieve predictable outcomes for the treatment of complex cases in an efficient manner.

Outcomes of a 1-Year Prospective Single-Arm Cohort Study Using a Novel Macro-Hybrid Implant Design in Extraction Sockets: Part 1.

A novel macro-hybrid implant design was introduced to afford high apical primary stability and more coronal space to preserve the circumferential extraction socket architecture. This study presents 1-year data from a prospective single-arm cohort study. The data was distilled based on the following criteria: (1) single-tooth immediate tooth replacement therapy (ITRT) in the maxillary anterior and premolar regions in intact (Type 1) extraction sockets that were (2) treated with the dual-zone grafting technique. The clinical and radiographic outcomes of 48 ITRT implants were evaluated. The mean ± SD labial plate dimension changes were 0.33 ± 0.41 mm at the implant abutment interface (L1) and 0.34 ± 0.40 mm at 5.0 mm below (L2). The mean labial plate dimension (thickness) at the 1-year recall was 2.27 ± 0.88 mm (L1) and 1.95 ± 0.95 mm (L2). At ITRT, the ridge contour at the free gingival margin and 3.0 mm below it were 7.54 ± 0.93 mm and 9.44 ± 2.36 mm, respectively; after final restoration delivery, the corresponding values were 7.45 ± 0.95 mm and 10.23 ± 2.30 mm, respectively. The peri-implant soft tissue thickness (PISTT) at the time of implant-level impression-making was 3.29 ± 0.73 mm, with an average Pink Esthetic Score of 12.79. A macro-hybrid implant design showed high levels of primary stability (~60 Ncm), stable ridge contour at 1 year, a labial plate dimension between 1.5 and 2.0 mm, and PISTT > 3.0 mm, which may be a critical factor in providing stable, long-term esthetic outcomes.

CAD/CAM Fabrication of Definitive Implant Prostheses: A Digital Workflow From Planning to Implant Placement to Final Restoration.

Traditional methods of performing dental implant surgery and fabricating a definitive implant-supported prosthesis are being supplanted by digital techniques that provide greater precision and a more durable and esthetic restoration. In the present case, a 68-year-old woman presented a severely compromised dentition. She had received extensive restorative dentistry in the past and, due to recurrent caries and chronic periodontitis, was facing the loss of her maxillary teeth, as well as teeth in the lower left quadrant. This case report illustrates the use of a number of digital techniques for both treatment planning and fabrication of the final restoration.

A new implant design for crestal bone preservation: initial observations and case report.

Following the exposure and restoration of two-piece dental implants, some change in the vertical level of the peri-implant crestal bone height has been reported. This change in crestal bone height has not, however, negatively impacted long-term implant success. This article describes how the concept of platform switching is incorporated into a new implant design as a means of reducing or eliminating the occurrence of crestal bone loss. Preliminary observations from clinicians utilizing this new implant design are herein presented.