A Digital Workflow for an Implant Retained over Denture: A New Approach
Journal Title: Biomedical Journal of Scientific & Technical Research (BJSTR) - Year 2018, Vol 6, Issue 5
Abstract
The development of digital technologies in dentistry has changed the therapeutic approach in edentulous patients both in the preliminary stages of clinical case studies and when supporting the actual fabrication phases. The goals of digital fabrication are to reduce the number of patient appointments and improve the predictability of treatment outcome. A thorough description of a complex clinical case analyzes how these new digital technologies are used in every step of the prosthetic therapy to perform the reconstruction of a bar retained overdenture. For some years, modern prosthetic dentistry has been making use of digital technologies to support both the diagnostic and therapeutic stages of patient rehabilitation [1-4]. The traditional removable and implant-supported denture has also benefited from these innovations and has been further digitally developed both in the virtual planning of clinical cases and as support during the actual fabrication phase [5,6]. The purpose of digital fabrication of complete dentures and overdentures is to reduce the number of patient appointments and improve the predictability of treatment outcome [7]. Nonetheless, no standardized procedure has been determined for the digital fabrication of removable prostheses starting from the communication with patients to the construction of prostheses in the dental laboratory. Current analogous work steps and digital fabrication approaches have yet to be integrated and linked to one complete digital workflow. For this reason a new area of application for CAD technology is presented for prosthetic treatment, particularly for bar retained overdentures through a new specific software called Digital Smile SystemR(DSS, Digital Smile System DSS). DSS is a software composed of tools and a data library of natural and artificial teeth used in interdisciplinary dentistry to improve diagnostic vision, develop communication/information, and enhance predictability throughout the course of treatment (restorative, surgical, and prosthetic) [8,9]. This system employs two photographs of the patient’s face that can be processed to create a clinical, functional, and esthetic design of the smile. DSS is used not only as a means for dentist/patient dialogue, but also as a work tool for transferring to the dental technician all the information needed to create the prosthetic artefact, limiting to a minimum both the clinical trials and the analogue laboratory stages.The aim of this clinical report is to describe the application of these digital technology advancements in overdenture implant rehabilitation through the description of a complex clinical case. A 68-year-old female patient came to the dental office complaining of reduced chewing ability and loss of retention of her upper removable complete denture present in the oral cavity. She furthermore asked to improve the esthetics of her smile and face, lamenting that she was dissatisfied with the color and visibility of her teeth which, even when facial mimicry was more accentuated, were scarcely noticeable and featured unnatural slanted planes. The medical history showed no pathology incompatible with dental therapy and an overall good state of health: the patient was classified as ASA1.The esthetic analysis of the facial appearance showed a reduction of the vertical dimension of occlusion with an increase in perilabial wrinkles and the upper teeth were not visible in the rest position. Furthermore, the musculature of the cheeks was unsupported by the old prosthesis, and the entire face had visibly lost tone (Figure 1). The patient exhibited an unpleasant, slanted smile with a disharmonious aspect.The clinical intraoral analysis showed that the upper denture was unsatisfactory because of an inadequate extension of the prosthetic bodies, incorrect occlusal contacts, and an inadequate intermaxillary relationship. In the lower arch, a recently produced bar retained overdenture was present.
Authors and Affiliations
Luca Ortensi, Riccardo Stefani, Ilaria Caviggioli
Keywords
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- EP ID EP585823
- DOI 10.26717/BJSTR.2018.06.001408
- Views 180
- Downloads 0
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