28 September 2022

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Immediate load with a post extraction implant with a digital workflow

Author: Dario Cianci

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Digital dentistry requires the use of intra- oral scanners allowing the simplification of the impression phase, dramatically improving the workflow for the dentist work with significant benefits for the patient. In this way standard impressions are no longer needed with the possibility of execution of the chairside prosthetic product that could be delivered within few hours. When digital dentistry is applied to implant dentistry, the virtual diagnostic phase and surgery design, reduces the possibility of clinical errors and could also increase the chance to implant placement where orthopantomography seems to indicate an

insufficient available bone level. The soft- ware allows, in fact, very easily the super- imposing of cone beam images to those of the intraoral scanner for the design of surgical guides that can be produced in the studio or sent to third parties. The presence of the cone beam x-ray, the intraoral scanner, and a miller, represent a substantial change in the vision of the work plan and the time of execution by the clinicians. It represents an important change in the daily dentist workflow. In the present study, the author proposed a clinical case of immediate loading of a post-extraction implant following a complete digital workflow system.

MATERIALS AND METHODS

The clinical case proposed showed a vertical fracture of the element 2.5, with the need of tooth extraction and implant placement. After orthopantomography x-ray, a cone beam of the area was recorded to evaluate the bone lev- el, and then using the software Galileo Galaxis a virtual plan of the surgical placement of the implant was performed. Using a CAD/CAM system associated to a milling machine, the chairside system was able to produce in a short time, the manufactured prosthesis and provide it to the patient in a single visit. 

RESULTS AND CONCLUSIONS

The CAD/CAM procedure provides a chairside system that considerably reduces the procedure time for operator and patient. It allows the use of the latest generation prosthetic materials with excellent aesthetic quality and biocompatibility. Without a digital workflow, the classic print is delivered to the dental technician who develops it, creates the prosthetic artifact, sends it back to the dentist who places it on the patient by verifying their fitness, then hand it back to the finish technician. These steps normally require few days while in the digital workflow process are reduced to few hours. In conclusion although digital dentistry is still associated to high costs, the benefits associated in terms of quality, execution time and patients comfort made it a reality that will become more and more widespread in dental care.

CLINICAL SIGNIFICANCE

Digital dentistry requires the use of intraoral scanners allowing the simplification of the impression phase, dramatically improv- ing the workflow for the dentist work with significant benefits for the patient. The CAD/CAM procedure provides a chairside system that considerably reduces the procedure time for operator and patient and it allows the use of the latest generation prosthetic materials with excellent aesthetic quality and biocompatibility.