J Dent Rehabil Appl Sci.  2023 Dec;39(4):250-259. 10.14368/jdras.2023.39.4.250.

Multiple fixed implant-supported prosthesis using temporary denture and scannable healing abutment: a case report

• Kim HJ
• Kim H
• Jang Wh
• Yun Kd
• Park SW
• Lim HP

• KMID: 2550434
• DOI: http://doi.org/10.14368/jdras.2023.39.4.250

Abstract

The use of digital technology in fixed prosthetic treatment using implants enables predictive treatment through diagnosis and virtual surgery by integrating clinical and radiological information of patients. Existing digital scanning methods require several components to be removed, such as removing the healing abutment and connecting the scan body. In the scannable healing abutment developed in consideration of this point, scanning is performed directly on the healing abutment, maintaining soft tissue sealing and simplifying scanning. Digital technology can also be used when obtaining the intermaxillary relationship. Recently, various digital technologies have been reported to acquire the intermaxillary relationship of edentulous patients using surgical guides, patient-specific scanning devices, or scans of the inside of temporary dentures. In this case, the implant-supported fixed prosthesis treatment was performed through scanning the scannable healing abutment and the inner side of the temporary denture to obtain the intermaxillary relationship, thereby simplifying the treatment process and obtaining aesthetically and functionally excellent clinical results.

Keyword

implant-supported fixed prosthesis; scannable healing abutment; temporary denture

Figure

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  Fig. 1 Initial intraoral photographs. (A) Initial panoramic radiography, (B) Maxillary occlusal view, (C) Frontal view, (D) Mandibular occlusal view.

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  Fig. 2 Implant planning using R2GATE software. (A) Radiopaque occlusal rim, (B) Digital wax up, (C) Planned implant position of maxilla, (D) Planned implant position of mandible, (E) 3D printing surgical guide of maxilla, (F) 3D printing surgical guide of mandible.

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  Fig. 3 Mandibular anterior tooth state with Intraoral photo. (A) Frontal view, (B) Occlusal view, (C) Periapical radiography.

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  Fig. 4 Post-operative images after implant stage surgery. (A) Panoramic radiograph with healing scan abutment, (B) Occlusal view of maxilla with healing scan abutment, (C) Occlusal view of mandible with healing scan abutment.

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  Fig. 5 Temporary denture relining with tissue conditioner. (A) Frontal view, Inner surface of temporary denture of (B) Maxilla, (C) Mandible.

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  Fig. 6 Superimposition between temporary denture scan data and intraoral scan data. Intraoral scan data of (A) Maxilla, (B) Mandible. Temporary denture scan data of (C) Maxilla, (D) Mandible and Inverted scan data of (E) Maxilla, (F) Mandible. (G) Frontal view, (H) Sagittal view of alignment of scan data with facial scan data and evaluation of occlusal plane.

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  Fig. 7 Design of provisional prosthesis with superimposition data by Exocad. (A) Frontal view, (B) Sagittal view.

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  Fig. 8 Provisional prosthesis. (A) Occlusal view of maxilla, (B) Right lateral view, (C) Fontal view, (D) Left lateral view, (E) Occlusal view of mandible.

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  Fig. 9 (A) Bite taking with bite impression material, Abutment level impression of (B) Maxiila, (C) Mandible, (D - F) Cross mounting for definitive prosthesis, (G, H) Mandibular movement record with Arcus digma.

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  Fig. 10 Delivery of definitive prosthesis (Posterior part). (A) Occlusal view of maxilla, (B) Right lateral view, (C) Fontal view, (D) Left lateral view, (E) Occlusal view of mandible, (F) Extraoral photograph (initial visit), (G) Extraoral photograph (after definitive prosthesis delivery).

Reference

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