07 July 2023

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Streamlining gingival emergence profile management: exploring the copy-paste concept of digital workflows

By Lorenzo Breschi and Carlo D’Alessandro

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Over the past decade, digital technologies have radically changed the dental practice. Advancements in intra-oral scanners, software programs, milling machines and 3D printers have enabled the adoption of full digital workflows for fixed prosthetic rehabilitations.

The aesthetic outcome of dental treatments relies heavily on the natural integration of prosthetic restorations with the surrounding periodontal or peri-implant soft tissue. Once a harmonious restoration profile is established and the desired soft tissue architecture is achieved through the fabrication of the temporary prosthesis, it is crucial to communicate effectively with your dental technician. Traditional methods of taking impressions have been used for years in fixed prosthodontics. However, digital technologies have led to several advantages for clinicians, technicians and patients.

In this regard, Agnini et al. introduced the copy-paste full digital workflow for transferring the definitive emergence profile and angle for fixed restorations on natural teeth and dental implants.

Clinical technique and discussion

The copy-paste approach involves a series of five or six scans, on natural teeth or dental implants respectively:

1. scan of the arch with the temporary prosthesis in place
   
   
2. scan of the opposing arch
   
   
3. bite scan in maximum intercuspation
   
   
4. scan of the teeth abutments or the scan body in high definition
   
   
5. scan of the temporary restoration chair-side, and
   
   
6. scan of the arch without the temporary prosthesis (for dental implants only).

Utilizing a CAD software, all the scans can be superimposed to generate a highly precise virtual model. The dental technician can manipulate the transparencies to visualize the shape and the volume occupied by the temporary prosthesis as well as the soft tissue profile. The final prosthesis is designed as an exact copy of the provisional which has been placed in the patient's mouth. It will contain all the clinically tested information in terms of tissue support, aesthetics, phonetics and function.

Conclusions

The authors concluded that the copy-paste full digital workflow can enhance the communication between clinicians and technicians. With this approach, the definitive prosthesis is manufactured as a precise replica of the temporary prosthesis, capturing its morphology and gingival emergence profile transferred through intra-oral scans.

Agnini A, Romeo D, Giulia B, Tommaso W, Christian C, Agnini A. “Copy-paste concept: Full digital approach in the management of gingival emergence profiles.” J Esthet Restor Dent. 2023 Jan;35(1):222-229.