A digital approach integrating facial scanning in a CAD-CAM workflow for complete-mouth implant-supported rehabilitation of patients with edentulism: A pilot clinical study

B. Hassan, B. Gimenez Gonzalez, A. Tahmaseb, M. Greven, Daniel Wismeijer

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

Statement of problem: Complete-mouth implant-supported rehabilitations are challenging because of the multiple surgical and prosthetic steps involved in clinical evaluations to assure passive prosthesis fit and optimal esthetic and functional outcomes. As a result, these rehabilitations are usually associated with substantial clinical time, patient discomfort, and high treatment cost.

Purpose: The purpose of this pilot clinical study was to evaluate a novel digital approach integrating digital intraoral dental and extraoral facial scanning information to design and mill a computer-aided design and computer-aided manufacturing (CAD-CAM) implant-retained prosthesis for patients with complete edentulism.

Material and methods: Ten patients in need of complete-mouth rehabilitation were included in this pilot study. Digital intraoral records were obtained through optical scanning the duplicate interim prosthesis using a laboratory scanner, while digital extraoral records were obtained through facial scanning using an in-office scanner. The scanned impressions and occlusal records were used to create a virtual tooth arrangement, which was matched to the patient's 3-dimensional face scan to create a virtual clinical evaluation phase. After applying the necessary adjustments, the virtual arrangement was submitted to a CAM procedure where a 5-axis industrial milling machine was used to fabricate an interim prosthesis.

Results: Digital intraoral and extraoral records were integrated and used to fabricate CAD-CAM milled interim prostheses, which were inserted and assessed for clinical fit, occlusion/articulation, and esthetics. The prostheses remained in function for at least 6 months with no notable technical or biological complications except for 1 prosthesis that fractured.

Conclusions: A novel digital workflow incorporating facial scanning in a CAD-CAM workflow was used to fully digitally design and mill 10 implant-retained interim prostheses. More research is required to further develop and assess the accuracy and applicability of this approach.

Original languageEnglish
Pages (from-to)486-492
JournalJournal of Prosthetic Dentistry
Volume117
Issue number4
Early online date27 Oct 2016
DOIs
Publication statusPublished - Apr 2017

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