A FULLY DIGITAL PLANNING AND MANUFACTURING OF AN AESTHETICALLY CONCEIVED AND GUIDED FULL-ARCH IMPLANT-SUPPORTED REHABILITATION

T. Tealdo¹, M. Bevilacqua², L. Scaglione¹, C. Alberti³, P. Montagna⁴ and F. Gelpi⁴

¹Private Practitioner in Alba (CN), Italy;
²Private Practitioner in Boves (CN), Italy;
³Private Practitioner in Rosà (VI), Italy;
⁴Head and Neck Department, Department of Surgery, Dentistry, Pediatrics and Gynecology, University of Verona, Verona, Italy

Correspondence to:
Federico Gelpi, DDS
Head and Neck Department,
Department of Surgery, Dentistry, Pediatrics and Gynecology,
University of Verona,
Verona, Italy
e-mail: federico.gelpi@libero.it

Received: 9 January 2024 Accepted: 20 February 2024

ISSN 2975-044X (online) ISSN 2038-4106 (print) Copyright © by BIOLIFE 2024 This publication and/or article is for individual use only and may not be further reproduced without written permission from the copyright holder. Unauthorized reproduction may result in financial and other penalties. Disclosure: All authors report no conflicts of interest relevant to this article.

ABSTRACT

                In the rapidly evolving implant dentistry scenario, integrating digital technologies has significantly advanced the precision and efficiency of treatments, especially in full arch implant-supported rehabilitations. Despite these advancements, a completely digital approach to complex cases remains difficult and very challenging, necessitating a hybrid approach that utilizes both digital and traditional techniques. This technical note delineates a combined digital workflow for aesthetically guided, full arch implant-supported rehabilitations in the upper jaw, avoiding the need for interim dentures. Integrating a precise analogical plaster implant impression, advanced digital scanning and planning, mandibular movement registration (ITAK®), and face scans are possible by detecting a reference area defined by the palatine wrinkles. This approach aims to maximize aesthetic, functional, and biomechanical outcomes and addresses the ongoing debate about the accuracy of intraoral scanner scans versus traditional impression methods for full arch restorations. Although digital methods are increasingly favored for their efficiency and potential for trueness and precision, our procedure underscores the relevance of detecting an anatomical area as a reference. Through a detailed technical note, this paper showcases a reproducible protocol that combines the effectiveness of analogic plaster impressions with the benefits of digital planning and Computer-Aided Manufacturing, representing a step towards the future of implant dentistry where digital processes may fully supplant traditional procedures for the immediate loading and the further final prosthetic restoration, enhancing patient outcomes through more accurate and efficient treatment modalities.

KEYWORDS: full upper arch, hopeless teeth, aesthetic analysis, intraoral scanner, IOS, scanface, ITAKA® comfort position, CBCT, Exocad®