A completely digital workflow for an interim implant-supported crown: A clinical report

Effect of prefabricated immediate interim prosthesis design and insertion workflow on seating accuracy on implants placed via static computer-assisted implant surgery: A cross-sectional in vitro study

BACKGROUND

Immediate implant restoration by prefabricated prosthesis has multiple benefits. However, the design and insertion workflow of the prosthesis may influence the seating.

PURPOSE

Evaluation of seating accuracy of prefabricated interim prosthesis of different designs and insertion workflows for immediate restoration of implants placed via static computer-assisted implant surgery (sCAIS).

MATERIALS AND METHODS

A maxillary model without incisors was used to plan for two implants at the lateral incisor locations. According to the planned implants, sCAIS surgical template and a four-unit interim prosthesis were designed. Four prostheses were fabricated based on the design and insertion workflow. The first prosthesis involved complete fabrication (CF) of the interim prosthesis, where the interim prosthesis is fabricated for laboratory attachment to abutments. The other three prostheses were produced by partial fabrication (PF), where the interim prosthesis shell was produced with internal spacing between the fitting surface and the abutments. The PF prostheses were cemented on abutments attached to the inserted implants. Three different PF prosthesis designs were included with different levels of internal spacing: 100 μm (PF.1), 200 μm (PF.2), and 300 μm (PF.3). A total of 15 surgical models received implants on which each prosthesis was seated and scanned by a laboratory scanner. The vertical, horizontal, and proximal contact errors were measured.

RESULTS

Although all prostheses were seated on every model, the CF prostheses had greater vertical error, followed by PF.1, PF.2, and PF.3 prostheses, respectively. A similar pattern was observed for proximal contact error, where PF.3 was most superior. PF.3 prostheses had the least horizontal error than the other prostheses.

CONCLUSIONS

All interim prostheses experienced errors at the vertical, horizontal, and proximal surfaces, which can be attributed to deviations of the inserted implants. The PF of interim prosthesis with increased internal spacing for intraoral insertion appeared to reduce seating errors.

A digital workflow for the fabrication of an immediate implant-supported interim restoration

Immediate interim restorations in the esthetic region are usually fabricated in situ by using the pick-up technique, which is time-consuming and has a potential for cross-infection. This article describes a rapid and precise workflow for the fabrication of an immediate implant-supported interim restoration. A cast with gingival contours and an extended tube to accommodate the implant analogs is generated preoperatively based on the virtual implant planning and a predesigned restoration. After guided osteotomy and implant insertion, the actual three-dimensional (3D) implant position is transferred precisely from the mouth to the printed cast by using the surgical guide. This technique can achieve the rapid and precise fabrication of the interim restoration with guidance immediately after the surgery, decreasing the risk of cross-infection and reducing clinical steps and time.

A straightforward protocol for designing an interim hollow shell with open-source software

BACKGROUND

An interim hollow shell (IHS) is a temporary prosthesis that adapts like a cap over a prepared tooth abutment. Using a conventional protocol to fabricate IHS from casts of the initial situation or the wax-up can be challenging, time-consuming, and sometimes frustrating. A digital workflow makes this process quicker and more convenient. The IHS must be first designed with computer-aided design (CAD), then fabricated with computer-aided manufacture (CAM). Proprietary dental software is commonly used for the design process but needs to be purchased.

OBJECTIVE

To describe a step-by-step technique for designing an IHS for posterior relining with open-source software.

METHODS

This paper describes a straightforward procedure to design an IHS from a dental scan of the initial situation or a digital wax-up for an esthetic and functional temporary rehabilitation.

RESULTS

An IHS can be quickly designed using open-source software by copying an existing restoration or a conventional or digital wax-up. Then, the design can be 3D printed using a biocompatible resin.

CONCLUSIONS

The clinician can use open-source software to design IHSs, which are then 3D printed using a biocompatible resin.

CLINICAL RELEVANCE

The clinician can design IHSs from a dental scan of the initial situation or a wax-up using open-source software by following the step-by-step protocol outlined in this paper. The restoration can then be 3D printed using a biocompatible resin.