J Korean Acad Prosthodont.  2019 Jul;57(3):288-295. 10.4047/jkap.2019.57.3.288.

Full mouth rehabilitation of patient with severe dental caries with implant fixed prosthesis fabricated with milling and 3D printing method: A case report

• Kim T
• Lee JS
• Hong SJ
• Kim HS
• Kwon KR

• KMID: 2453784
• DOI: http://doi.org/10.4047/jkap.2019.57.3.288

Abstract

Passive fit of prosthesis is an essential property of implant supported prosthesis for long term success and minimization of complications. And the property is determined mostly by fabrication procedure. There were limitations of extensive implant prosthesis because conventional casting method generate contraction error of long span prosthesis. However, Computer-aided design/Computer-aided manufacturing (CAD/CAM) technology of 3D printing and milling metal framework can overcome those limitations. This case is a full mouth rehabilitation using extensive implant fixed prosthesis. Removable interim prosthesis was made for esthetic, functional evaluation and a guide for implant insertion. After the insertion, implant fixed interim prosthesis was delivered. After additional evaluation and adjustment, final prosthesis was designed with CAD, the fabricated with CAM. Milling technique was used for anterior screw type implant superstructure and 3D printing technique was used for the anterior and posterior implant copings. Fit of the final restoration was favorable. The practitioner and patient were both esthetically and functionally satisfied with the final result.

Keyword

Extensive implant fixed prosthesis; CAD/CAM; Milling; 3D printing

MeSH Terms

Dental Caries*
Humans
Methods*
Mouth Rehabilitation*
Mouth*
Printing, Three-Dimensional*
Prostheses and Implants*

Figure

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  Fig. 1 Preoperative intraoral photograph & panoramic view. (A) Smile view, (B) Frontal view, (C) Panoramic view.

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  Fig. 2 Removable interim restoration. (A) Intraoral photograph after extraction, (B) Removable interim restoration.

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  Fig. 3 Impant installation. (A) Preoperative intraoral view, (B) Operative view, (C) Postoperative view, (D) Postoperative panoramic view.

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  Fig. 4 Final impression procedure. (A) Intraoral view after 2nd surgery, (B) Impression coping, (C) Upper master model, (D) Intraoral view after final preparation, (E) Upper final impression, (F) Lower master model.

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  Fig. 5 Screw retained fixed interim restoration. (A) Frontal view, (B) Occlusal view.

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  Fig. 6 Framework CAD design. (A) Superstructure design, (B) Mx. Anterior design, (C) Mx. Anterior cutback, (D) Right posterior design, (E) Lower anterior design, (F) Left posterior design, (G) Right posterior cutback, (H) Lower anterior cutback, (I) Left posterior cutback.

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  Fig. 7 Implant superstructure and coping fabricated with CAM. (A) Right view, (B) Frontal view, (C) Left view.

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  Fig. 8 Final prosthesis. (A) Upper occlusal view, (B) Canines and 1st premolars cement retained type crowns, (C) Right view, (D) Frontal view, (E) Left view, (F) Lower occlusal view.

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  Fig. 9 Final prosthesis setting. (A) Intraoral photograph, (B) Smile photograph, (C) Panoramic radiograph after treatment.

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