Nowicki Adam, Osypko Karolina
Diamante Clinica Dental Clinic, Sportowa 48 A/C, 59-300 Lubin, Poland.
Platinum Clinic, Księcia Witolda 49, 50-202 Wrocław, Poland.
Reports (MDPI). 2023 Nov 1;6(4):52. doi: 10.3390/reports6040052.
Complex implant reconstructions in patients with residual dentition due to periodontitis is a challenging task in many aspects.
This study shows a full digital workflow combining 3D printing, guided implant placement, intraoral scanning and welding with immediate loading and digital smile design. An analog impression was taken to validate the passive fit of final restorations. The whole treatment plan was divided into three stages. The first stage included an intraoral scan of baseline dentition, and then the extraction of all teeth was performed, implanting four temporary implants and providing the patient with removable temporary prosthesis. The second stage was to scan the removable temporaries, implanting 10 implants and multi-unit abutments (MUA), and create a rigid construction via the intraoral welding of titanium bar and by fixing it to the 3D-printed temporary reconstructions (designed with DSD) as a form of immediate loading. The third stage included the scanning of screw-retained temporary reconstructions, then scanning from the MUA level and creating final reconstruction.
The presented workflow enabled the delivery of some sort of restoration to the patient at every moment of the treatment and to sustain the required esthetic effect with decent comfort of use even in the early stages.
A full digital workflow is a reliable treatment method even in complex cases.
对于因牙周炎导致牙列缺损的患者进行复杂的种植修复在很多方面都是一项具有挑战性的任务。
本研究展示了一种全数字化工作流程，该流程结合了3D打印、引导式种植体植入、口内扫描以及焊接，并进行即刻负重和数字化微笑设计。采用模拟印模来验证最终修复体的被动适合性。整个治疗计划分为三个阶段。第一阶段包括对基线牙列进行口内扫描，然后拔除所有牙齿，植入4颗临时种植体，并为患者提供可摘式临时假牙。第二阶段是对口内可摘式临时假牙进行扫描，植入10颗种植体和多单位基台（MUA），通过钛棒的口内焊接创建一个刚性结构，并将其固定到3D打印的临时修复体（采用DSD设计）上以实现即刻负重。第三阶段包括对螺丝固位的临时修复体进行扫描，然后从MUA层面进行扫描并创建最终修复体。
所展示的工作流程能够在治疗的每个阶段都为患者提供某种形式的修复，并即使在早期阶段也能以良好的使用舒适度维持所需的美学效果。
即使在复杂病例中，全数字化工作流程也是一种可靠的治疗方法。
