Bryan T. Harris

The use of a scannable impression coping and digital impression technique to fabricate a customized anatomic abutment and zirconia restoration in the esthetic zone.

This report described the fabrication of a customized anatomic abutment and zirconia restoration in the esthetic zone with a digital pathway. The implant level impression was made with a scannable impression coping and intraoral digital scanner. The milled definitive polyurethane cast with corresponding implant analog, customized anatomic abutment, and definitive zirconia restoration were made with a computer-aided design and computer-aided manufacturing (CAD/CAM) process.

Use of digital data acquisition and CAD/CAM technology for the fabrication of a fixed complete dental prosthesis on dental implants

The work flow in this report describes a metal-resin fixed complete dental prosthesis fabricated by using digital data acquisition at the implant fixture level with a computer-aided design and computer-aided manufacturing (CAD/CAM) fabricated tissue-colored anodized titanium framework.

Use of implant-supported interim restorations to transfer periimplant soft tissue profiles to a milled polyurethane definitive cast.

A customized impression coping is often used in conjunction with conventional implant impression techniques to transfer a well-defined periimplant soft tissue profile resulting from an implant-supported interim restoration to the definitive cast with a removable gingival replica and achieve the desired esthetic outcome of the definitive restorations. However, a direct line of sight between the intraoral scanner and the periimplant soft tissue is needed during the data acquisition of the digital impression techniques, and it is not possible to use customized scannable impression copings to support periimplant soft tissue. This study describes a clinical technique with implant-supported interim restorations to transfer desired periimplant soft tissue profiles to the milled definitive polyurethane cast with a removable periimplant soft tissue replica to maximize the esthetic outcome of the definitive restorations.

Use of intraoral digital scanning for a CAD/CAM-fabricated milled bar and superstructure framework for an implant-supported, removable complete dental prosthesis.

This report describes a clinical technique for fabricating a maxillary implant-supported, removable complete dental prosthesis by using an intraoral digital scanner to register implant positions and soft tissue morphology. The presented technique uses computer-aided design/computer-aided manufacturing (CAD/CAM) technology with a subtractive manufacturing process to fabricate a milled bar (infrastructure framework) and an additive process to fabricate a friction fit, superstructure framework. This digital restorative pathway may decrease patient discomfort and reduce the labor associated with fabricating implant-supported, removable complete dental prostheses.

Creation of a 3-dimensional virtual dental patient for computer-guided surgery and CAD-CAM interim complete removable and fixed dental prostheses: A clinical report

This clinical report proposes a digital workflow using 2-dimensional (2D) digital photographs, a 3D extraoral facial scan, and cone beam computed tomography (CBCT) volumetric data to create a 3D virtual patient with craniofacial hard tissue, remaining dentition (including surrounding intraoral soft tissue), and the realistic appearance of facial soft tissue at an exaggerated smile under static conditions. The 3D virtual patient was used to assist the virtual diagnostic tooth arrangement process, providing patient with a pleasing preoperative virtual smile design that harmonized with facial features. The 3D virtual patient was also used to gain patients pretreatment approval (as a communication tool), design a prosthetically driven surgical plan for computer-guided implant surgery, and fabricate the computer-aided design and computer-aided manufacturing (CAD-CAM) interim prostheses.

Effect of Implant Divergence on the Accuracy of Definitive Casts Created from Traditional and Digital Implant-Level Impressions: : An In Vitro Comparative Study

PURPOSE The purpose of this research was to compare the accuracy of definitive casts created with digital and conventional methods for implants with internal-octagon connections placed parallel or at different angles (15, 30, or 45 degrees). MATERIALS AND METHODS Four customized epoxy resin master casts were fabricated with two-implant analogs placed in the posterior mandible with different degrees of divergence. For the conventional (control) group, 10 traditional impressions were taken on each master cast with custom trays, open-tray impression copings, and polyvinyl siloxane; definitive stone casts were poured with type IV dental stone. For the digital group, 10 digital impressions were taken on each master cast with two-piece scannable impression copings and an intraoral digital scanner; definitive milled polyurethane casts were fabricated by the manufacturer. All four master casts and 80 control and test casts were scanned and digitized, and the data sets were compared. Any deviations in measurements between the definitive and corresponding master casts were analyzed statistically. RESULTS The amount of divergence between implants did not affect the accuracy of the stone casts created conventionally; however, it significantly affected the accuracy of the milled casts created digitally. A decreasing linear trend in deviations for both distance and angle measurements suggested that the digital technique was more accurate when the implants diverged more. At 0 and 15 degrees of divergence, the digital method resulted in highly significantly less accurate definitive casts. At 30 and 45 degrees of divergence, however, the milled casts showed either no difference or marginal differences with casts created conventionally. CONCLUSION The digital pathway produced less accurate definitive casts than the conventional pathway with the tested two-implant scenarios. To ensure passive fit of definitive prostheses, verification devices and casts may be used when materials are produced digitally.

Maxillary rehabilitation with a CAD/CAM-fabricated, long-term interim and anatomic contour definitive prosthesis with a digital workflow: A clinical report

The digital workflow in this clinical report describes a maxillary rehabilitation with an articulator-free and definitive cast-free treatment protocol for computer-aided design and computer-aided manufacturing (CAD/CAM) fabricated long-term interim and anatomic contour monolithic lithium disilicate definitive restorations.

Use of prefabricated titanium abutments and customized anatomic lithium disilicate structures for cement-retained implant restorations in the esthetic zone.

This report describes the fabrication of customized abutments consisting of prefabricated 2-piece titanium abutments and customized anatomic lithium disilicate structures for cement-retained implant restorations in the esthetic zone. The heat-pressed lithium disilicate provides esthetic customized anatomic structures and crowns independently of the computer-aided design and computer-aided manufacturing process.

Trial insertion procedure for milled lithium disilicate restorations in the precrystallized state

A treatment protocol with lithium disilicate restorations and a computer-aided design and computer-aided manufacturing (CAD/CAM) fabrication process is proposed for the restoration of teeth in the esthetic zone. The technique involves trial insertion of restorations at the precrystallized stage, allowing verification of the marginal fit and evaluation of the internal adaptation and overall esthetic plan to ensure an optimal clinical result for the definitive restorations. Furthermore, this procedure allows most adjustments to the lithium disilicate ceramic to be made before crystallization and minimizes potential surface and subsurface damage to the definitive restorations.

Maxillary and mandibular immediately loaded implant-supported interim complete fixed dental prostheses on immediately placed dental implants with a digital approach: A clinical report.

This clinical report describes the treatment of maxillary and mandibular immediate implant placement and immediately loaded implant-supported interim complete fixed dental prostheses with a contemporary digital approach. The virtual diagnostic tooth arrangement eliminated the need for a customized radiographic template, and the diagnostic data collection required for computer-guided surgery (digital diagnostic impressions, digital photographs, and a cone beam-computed tomography [CBCT] scan) was completed in a single visit with improved workflow efficiency. Computer-aided design and computer-aided manufacturing (CAD/CAM)-fabricated surgical templates and interim prosthesis templates were made in a dental laboratory to facilitate computer-guided surgery and the immediate loading process.