Abstract

Aim: A fixed full-arch prosthesis on immediate loading dental implants, designed in a complete digital workflow, requires the impressions of both dental arches, the exact position of the dental implants and the registration of the maxillo-mandibular relationship. In case of surgical interventions requiring significant modifications of the bone crest or the removal of all the teeth, with alteration and/or swelling of the soft tissues, it is difficult to have accurate and stable landmarks to match the pre-surgical and the post-surgical digital impressions. Therefore, the purpose of this study was to introduce a reliable method to overcome such problem and realize a fixed full-arch prosthesis on immediate loading dental implants by the use of a complete digital workflow.
Materials and methods: Prior to the surgical procedure and the digital impressions, two unique skeletal scan bodies, each one combined with a mini-implant, are positioned distally in the dental arch (one left and one right) where the dental implants are placed, to provide distinctive landmarks that remain unchanged after surgery. Such procedure allows a perfect matching between the pre-surgical and post-surgical scans, maintaining the information of the patient’s habitual occlusion in maximum intercuspation.
Result: The use of the skeletal scan bodies enables the oral surgeon to add the data of the patient’s maxillo-mandibular relationship to the digital work flow.
Conclusion: The present protocol allows to achieve the position of the implants and the patient’s maxillomandibular relationship in maximum intercuspation in the three dimensions with a single digital scan.

Keywords: Digital impression; Digital workflow; Full-arch prosthesis; Immediate loading; Habitual occlusion; CAD/CAM; Implant scan body; Skeletal scan body