J Korean Acad Prosthodont.  2019 Oct;57(4):397-404. 10.4047/jkap.2019.57.4.397.

Rehabilitation with implant-supported fixed dental prostheses using digital duplication technique on customized artificial tooth, interim denture and implant surgical template: A case report

• Jeong DG
• Oh KC
• Shim JS
• Park JM

• KMID: 2461147
• DOI: http://doi.org/10.4047/jkap.2019.57.4.397

Abstract

Bone and soft tissue conditions are important for successful implant treatment. But, the placement itself is also very important. Implants which is installed in the wrong position result in the biological, esthetical and mechanical problems. In order to place an implant in the correct position, the final restoration and diagnostic wax-up should be considered prior to the surgery. If the artificial teeth for the interim denture are directly transferred from the diagnostic wax-up, the operator can try the form of diagnostic wax-up in the mouth. If the surgical template is produced by duplicating the interim denture, the implant can be placed in the planned position. In this case, the polymethyl methacrylate (PMMA) artificial tooth was precisely milled by the digital duplication of diagnostic wax-up. And interim denture was fabricated by using these milled teeth. After the patient adapted for a sufficient period, the implant was placed at the planned position with surgical template produced by duplicating the interim denture. After confirming sufficient osseointegration, the final prostheses were made to reflect the shape of diagnostic wax-up. Through this procedure, the satisfactory functional and esthetic outcome could be acquired.

Keyword

Dental implant; Diagnostic wax up; Customized artificial tooth; Digital duplication technique

MeSH Terms

Dental Implants
Dental Prosthesis*
Dentures*
Humans
Mouth
Osseointegration
Polymethyl Methacrylate
Prostheses and Implants
Rehabilitation*
Tooth
Tooth, Artificial*
Dental Implants
Polymethyl Methacrylate

Figure

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  Fig. 1 Intraoral photograph. (A) Maxillary occlusal view, (B) Right lateral view, (C) Frontal view, (D) Left lateral view, (E) Mandibular occlusal view.

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  Fig. 2 (A) Frontal image of model after tooth removal, (B) Frontal image after Diagnostic wax up, (C) Maxilla superimposition image, (D) Mandible superimposition image, (E) Maxillary tooth STL file, (F) Mandibular tooth STL file.

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  Fig. 3 (A) Diagnostic wax up occlusal view of maxilla, (B) Diagnostic wax up left lateral view, (C) Diagnostic wax up occlusal view of mandible, (D) Tooth alignment occlusal view of maxilla, (E) Tooth alignment left lateral view, (F) Tooth alignment occlusal view of mandible, (G) Interim denture occlusal view of maxilla, (H) Interim denture left lateral view, (I) Interim denture occlusal view of mandible.

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  Fig. 4 (A) Image of Maxillary interim denture, (B) Mandibular interim denture, (C) Maxilla implant planning, (D) Mandible implant planning, (E) Maxilla implant surgical template, (F) Mandible implant surgical template.

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  Fig. 5 (A) Diagnostic wax up occlusal view of maxilla, (B) Custom abutment occlusal view of maxilla, (C) Zirconia crown design of Maxilla, (D) Diagnostic wax up occlusal view of mandible, (E) Custom abutment occlusal view of mandible, (F) Zirconia crown design of mandible.

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  Fig. 6 Final prostheses delivery. (A) Occlusal view of maxilla, (B) Right lateral view, (C) Frontal view, (D) Left lateral view, (E) Mandibular occlusal view.

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  Fig. 7 Superimposition between Diagnostic wax up (sky blue) and Final prostheses (white), (A) Maxilla Frontal view, (B) Maxilla right lateral view, (C) Maxilla left lateral view, (D) Mandible Frontal view, (E) Mandible right lateral view, (F) Mandible left lateral view.

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