News Feature

Comprehensive dental rehabilitation with digital workflow

Article by Michael Braian DDS, CDT, PHD

Digital advancements revolutionized dentistry, providing efficient, precise dental care¹. Intraoral scanners replace traditional impressions, enabling virtual models for procedures like implant placement, orthodontics, and prosthodontics². Scan bodies aid in digitizing implants, while CAD/CAM improves prosthesis design and fabrication³. Milling and 3D printing offer speed, accuracy, and complexity in creating dental prostheses⁴. These innovations promise a bright future for dental professionals and patients.

The integration of digital technologies in dentistry has brought about significant advancements in dental care1. This case study presents a comprehensive dental rehabilitation of a patient utilizing a digital workflow, including extraction, dentures, implant surgery, intraoral scanning, 3D printed try-ins, and the fabrication of the final monolithic prosthetic construction.

EXTRACTION OF SEVERELY DECAYED TEETH

The first step in the patient‘s dental rehabilitation involved the extraction of severely decayed teeth. This procedure was necessary to eliminate the source of infection and discomfort and to prepare the oral cavity for the subsequent steps in the rehabilitation process. The dentures are later used to simplify the guided surgery planning⁵. Following the extraction, the patient was provided with appropriate postoperative care instructions and a healing period was allowed before proceeding with the next steps (Fig.1).

Fig. 1. Severely decayed teeth prior to extraction.

DENTURES DURING THE HEALING PERIOD

During the healing period of approximately seven months, the patient was fitted with dentures to replace the extracted teeth. This temporary solution allowed the patient to maintain oral function, appearance, and confidence while the extraction sites healed, and the oral tissues prepared for the implant surgery⁶.

IMPLANT SURGERY

In the upper jaw, six implants were placed, while only four were placed in the lower jaw (Fig.2). This decision was based on the patient‘s individual needs and oral anatomy. Studies have shown that the number of implants required for optimal support and stability depends on various factors, including bone quality and quantity, implant position, and prosthesis design⁷. Research suggests that six implants in the upper jaw and four in the lower jaw are sufficient to provide adequate support for a full-arch fixed prosthesis, with high success rates and patient satisfaction reported⁷. Additionally, placing fewer implants can help reduce surgical time and cost, as well as minimize the risk of complications associated with multiple implant placements. Therefore, this approach was deemed appropriate for this particular patient‘s case.