1
|
Li J, Joda T, Revilla-León M, Saleh MHA, Chen Z, Wang HL. Recommendations for successful virtual patient-assisted esthetic implant rehabilitation: A guide for optimal function and clinical efficiency. J ESTHET RESTOR DENT 2024; 36:186-196. [PMID: 37792734 DOI: 10.1111/jerd.13142] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Revised: 09/12/2023] [Accepted: 09/16/2023] [Indexed: 10/06/2023]
Abstract
OBJECTIVE 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. OVERVIEW 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. CONCLUSION 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. CLINICAL SIGNIFICANCE 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.
Collapse
Affiliation(s)
- Junying Li
- Department of Biologic and Materials Sciences & Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Tim Joda
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Marta Revilla-León
- Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Washington, USA
- Kois Center, Seattle, Washington, USA
- Graduate Prosthodontics, School of Dental Medicine, Tufts University, Boston, Massachusetts, USA
| | - Muhammad H A Saleh
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Zhaozhao Chen
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| |
Collapse
|
2
|
Nimmawitt P, Sittikornpaiboon P, Jaemsuwan S, Arunjaroensuk S, Wang JC, Hung CC, Kaboosaya B, Pimkhaokham A. The stability of tetracalcium phosphate/titanium implants: A short-term follow-up study. J Dent Sci 2022; 17:1030-1034. [PMID: 35756796 PMCID: PMC9201655 DOI: 10.1016/j.jds.2022.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 02/03/2022] [Indexed: 11/17/2022] Open
Abstract
Background/purpose Materials and methods Results Conclusion
Collapse
Affiliation(s)
- Pawhat Nimmawitt
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Paknisa Sittikornpaiboon
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Svas Jaemsuwan
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Sirida Arunjaroensuk
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Jen-Chyan Wang
- Department of Prosthodontics, Kaohsiung Medical University Hospital, School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chun-Cheng Hung
- Department of Prosthodontics, Kaohsiung Medical University Hospital, School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Boosana Kaboosaya
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Atiphan Pimkhaokham
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
- Corresponding author. Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, 34 Henri Dunant Road Wangmai, Patumwan, Bangkok, 10330, Thailand.
| |
Collapse
|
3
|
Li J, Att W, Chen Z, Lepidi L, Wang HL, Joda T. Prosthetic articulator-based implant rehabilitation virtual patient: A technique bridging implant surgery and reconstructive dentistry. J Prosthet Dent 2021:S0022-3913(21)00514-X. [PMID: 34756772 DOI: 10.1016/j.prosdent.2021.09.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 09/01/2021] [Accepted: 09/02/2021] [Indexed: 11/19/2022]
Abstract
This technique report describes a fully digital workflow to create a prosthetic articulator-based implant rehabilitation (PAIR) virtual patient for complete-arch or complete-mouth implant rehabilitation. This workflow uses a custom gothic arch tracer during the cone beam computed tomography (CBCT) scan and a 3-dimensional virtual facebow when superimposing data. The PAIR virtual patient possesses reliable centric relation and vertical dimension of occlusion and is compatible with virtual articulators. Computer-aided implant planning and a digital prosthetic design can be seamlessly integrated by using this virtual patient.
Collapse
Affiliation(s)
- Junying Li
- Clinical Assistant Professor, Department of Biologic and Materials Sciences & Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, Mich
| | - Wael Att
- Professor and Chair, Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, Mass
| | - Zhaozhao Chen
- Graduate student, Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Mich
| | - Luca Lepidi
- Research Fellow and Clinical Lecturer, Department of Clinical and Experimental Medicine, University of Foggia School of Dentistry, Foggia, Italy
| | - Hom-Lay Wang
- Professor, Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Mich
| | - Tim Joda
- Professor, Department of Reconstructive Dentistry, University Center for Dental Medicine Basel, University of Basel, Basel, Switzerland.
| |
Collapse
|
4
|
Rocío V, Valenzuela D. Surface roughness implant-retained mandibular bar and ball joint overdentures and adherence of microorganisms. Eur J Dent 2018; 12:546-552. [PMID: 30369801 PMCID: PMC6178668 DOI: 10.4103/ejd.ejd_265_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objective: The aim of this study is to assess the surface roughness of the implant-retained mandibular bar overdenture (BOD) and the implant-retained mandibular ball joint overdenture (BJOD) in jaw and its relation with the adhesion of molds and yeasts and mesophyll aerobe, in time 30 and 180 days in mouth. Materials and Methods: Five-systems titanium bar CARES® and synOcta® Straumann® Dental Implant System, Holding AG Inc., Basel, Switzerland (BOD), and five-systems joint ball Klockner® Implant System; Soadco Inc., Escaldes-Engordany; Andorra (BJOD), were used in two parallel groups of five participants, in an essay to simple blind person. To 30 and 180 days, the overdentures were withdrawn and evaluated the Ra: ųm. SJ-301® Mitutoyo Corporation Inc., Kanagawa, Japan, and the adhesion of microorganisms (colony-forming unit/ml). Results: The results were as follows: the Ra: Um (30th and 180th): BOD, 0.965–1.351; BJOD, 1.325–2.384. Adhesion: Molds and yeasts, BOD, 2.6 × 102 and 4.6 × 103; BJOD, 3.0 × 102 and 5.3 × 104. Adhesion: Mesophyll aerobe, BOD, 3.8 × 106 and 5.8 × 106; BJOD, 4.3 × 106 and 7.1 × 107. Conclusions: At 30 days (P = 0.489), there were no differences in BOD and BJOD for adhesion of molds and yeasts and mesophyll aerobe between both overdentures. At 180 days (P = 0.723), there were differences in the adhesion of mold and yeast and mesophyll aerobe, being greater in BJOD.
Collapse
Affiliation(s)
- Valenzuela Rocío
- University of Barcelone, Spain & Gastrovital, National Council Science Technology and Technological Innovation, Peru
| | | |
Collapse
|
5
|
Reliability of Resonance Frequency Analysis as an Indicator of Implant Micromotion. IMPLANT DENT 2016; 25:783-788. [DOI: 10.1097/id.0000000000000498] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
6
|
Baggi L, Pastore S, Di Girolamo M, Vairo G. Implant-bone load transfer mechanisms in complete-arch prostheses supported by four implants: a three-dimensional finite element approach. J Prosthet Dent 2013; 109:9-21. [PMID: 23328192 DOI: 10.1016/s0022-3913(13)60004-9] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
STATEMENT OF PROBLEM Complete-arch restorations supported by fewer than 5 dental implants can induce unbalanced load transfer and tissue overloading, leading to excessive bone resorption and possible clinical failure. This is primarily affected by the cantilever length, the implant design and positioning, and the morphology and properties of the bone. PURPOSE The purpose of this study was to compare 2 different restorative techniques for complete-arch rehabilitations supported by 4 implants. The primary purpose was to highlight the possible risks of excessive stress and unbalanced load transfer mechanisms and to identify the main biomechanical factors affecting loading transmission. MATERIAL AND METHODS Three-dimensional (3D) numerical models of edentulous maxillae and mandibles restored with 2 techniques using 4 implants were generated from computed tomography (CT) images and analyzed with linear elastic finite-element simulations with 3 different static loads. The first technique used 2 vertical mesial implants and 2 tilted distal implants (at a 30 degree angle), and the second used vertical implants that fulfilled platform switching concepts. Bone-muscle interactions and temporomandibular joints were included in the mandibular model. Complete implant osseous integration was assumed and different posthealing crestal bone geometries were modeled. Stress measures (revealing risks of tissue overloading) and a performance index (highlighting the main features of the loading partition mechanisms) were introduced and computed to compare the 2 techniques. RESULTS Dissimilar load transfer mechanisms of the 2 restorative approaches when applied in mandibular and maxillary models were modeled. Prostheses supported by distally tilted implants exhibited a more effective and uniform loading partition than all vertical implants, except in the simulated maxilla under a frontal load. Tilted distal implants reduced compressive states at distal bone-implant interfaces but, depending on bone morphology and loading type, could induce high tensile stresses at distal crests. Overloading risks on mesial periimplant bone decreased when the efficient preservation of the crestal bone through platform switching strategies was modeled. CONCLUSIONS Numerical simulations highlighted that the cantilever length, the implant design and positioning, and the bone's mechanical properties and morphology can affect both load transmission mechanisms and bone overloading risks in complete-arch restorations supported by 4 implants. Distally tilted implants induced better loading transmission than vertical implants, although the levels of computed stress were physiologically acceptable in both situations.
Collapse
Affiliation(s)
- Luigi Baggi
- INMP Department of Social Dentistry and Gnathological Rehabilitation, University of Rome Tor Vergata, Rome, Italy.
| | | | | | | |
Collapse
|
7
|
Cheng AC, Ho KS, Loy A. Maxillofacial prosthodontic management of an ablative maxillary surgical defect using a combination of conventional obturator prosthesis and an early loading implant supported high-strength full ceramic fixed dental prosthesis. ACTA ACUST UNITED AC 2013; 33:13-8. [PMID: 23739318 DOI: 10.1016/j.sdj.2012.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Prosthodontic rehabilitation of maxillary defects and early loading of endosseous implants has been widely published. The combination of the aforementioned treatment modalities are seldom reported in peer reviewed journals. This article describes the clinical presentation, management and prosthodontic rehabilitation of the maxillary defect of a patient. Clinical and scientific concerns are discussed.
Collapse
Affiliation(s)
- Ansgar C Cheng
- Specialist Dental Group, Mount Elizabeth Hospital, Republic of Singapore; National University of Singapore, Republic of Singapore; University of Hong Kong, Hong Kong.
| | | | | |
Collapse
|
8
|
Paniz G, Chierico A, Tomasi P, Cuel S. A technique for immediate occlusal implant loading of a completely edentulous mandible: A clinical report. J Prosthet Dent 2012; 107:221-6. [DOI: 10.1016/s0022-3913(12)60064-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
9
|
Implant Primary Stability Determined by Resonance Frequency Analysis in Surgically Created Defects: A Pilot Cadaver Study. IMPLANT DENT 2010; 19:509-19. [DOI: 10.1097/id.0b013e3181fa7f6a] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
10
|
The management of an edentulous maxilla using a CAD/CAM-guided immediately loaded provisional implant prosthesis with screw-retained and cement-retained abutments: a clinical report. J Prosthet Dent 2009; 102:340-4. [PMID: 19961990 DOI: 10.1016/s0022-3913(09)00140-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Functional rehabilitation of edentulous jaws using a CAD/CAM-guided implant protocol is commonly recommended as a definitive treatment modality. A patient with an edentulous maxilla received 7 endosseous implants using a CAD/CAM surgical template. A provisional maxillary acrylic resin fixed complete denture was connected immediately after implant placement using a combination of screw-retained and cement-retained abutments.
Collapse
|
11
|
Bogaerde LV, Pedretti G, Sennerby L, Meredith N. Immediate/Early Function of Neoss Implants Placed in Maxillas and Posterior Mandibles: An 18-Month Prospective Case Series Study. Clin Implant Dent Relat Res 2008; 12 Suppl 1:e83-94. [DOI: 10.1111/j.1708-8208.2008.00135.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
12
|
Tee-Khin N, Cheng AC, Lee H, Wee AG, Leong EWJ. The management of a completely edentulous patient using simultaneous maxillary and mandibular CAD/CAM-guided immediately loaded definitive implant-supported prostheses: a clinical report. J Prosthet Dent 2008; 99:416-20. [PMID: 18514662 DOI: 10.1016/s0022-3913(08)00069-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Functional rehabilitation of a completely edentulous patient with removable prostheses is a clinical challenge. A patient with an edentulous maxilla and mandible received 6 endosseous implants in the maxilla and 5 implants in the mandible using CAD/CAM surgical templates. Definitive maxillary and mandibular implant-supported fixed complete dentures were connected immediately after implant placement using a CAD/CAM-guided implant surgical placement protocol.
Collapse
Affiliation(s)
- Neo Tee-Khin
- Restorative Dentistry, National University of Singapore, Singapore
| | | | | | | | | |
Collapse
|
13
|
Cheng AC, Tee-Khin N, Siew-Luen C, Lee H, Wee AG. The management of a severely resorbed edentulous maxilla using a bone graft and a CAD/CAM-guided immediately loaded definitive implant prosthesis: a clinical report. J Prosthet Dent 2008; 99:85-90. [PMID: 18262007 DOI: 10.1016/s0022-3913(08)00014-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Functional reconstruction of an occlusion with severe residual ridge resorption is a clinical challenge. Removable prostheses are unsuccessful in situations with severe bone resorption. A patient with an edentulous maxilla received bone grafts from the anterior iliac crest to augment the maxillary alveolar residual ridges. The maxilla underwent bilateral sinus lift in the posterior area and onlay bone graft on the anterior maxilla using platelet-rich plasma. Eight endosseous implants were placed using a CAD/CAM surgical template approximately 6 months after the bone augmentation procedure. A prefabricated definitive implant-supported fixed complete denture was connected immediately after implant placement using a CAD/CAM-guided surgical implant placement protocol.
Collapse
Affiliation(s)
- Ansgar C Cheng
- Mount Elizabeth Hospital, National University of Singapore, Singapore.
| | | | | | | | | |
Collapse
|