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educing treatment time with digital dentistry
restoration support. Multi-unit abutments
were used to correct the angle
of the two posterior implants and to
provide a common restorative platform
across all implant sites (Fig. 9).
The provisional prosthesis and surgical
guide were designed using the
occlusal and intaglio surface data from
the scan appliance (Fig. 10).
After segmenting the DICOM data
for density, models of the patient’s
mandibular arch (Fig. 11), provisional
denture (Fig. 12) and surgical guide
were 3-D printed, and then articulated
so the entire surgical and prosthetic
stack could be examined (Fig. 13).
Figure 9: After digitally evaluating the quality and
quantity of mandibular bone, implants and multi-unit
abutments were virtually placed with the appropriate
angling and depth for the patient’s bone morphology.
Figure 10: CAD technology was used to design the
provisional denture and surgical guide. Treatment
planning software helped ensure an accurate fit and
conformity to the patient’s anatomy and the virtually
placed implants.
The provisional was designed with
relief for the multi-unit temporary
cylinders (Fig. 14). The surgical guide
incorporated occlusal anatomy to function
with a bite index for anatomically
correct fixation of the guide. A surgical
index was constructed for precise
placement of the surgical guide at the
time of surgery (Fig. 15).
11 12
The provisional
prosthesis and
surgical guide were
designed using the
occlusal and intaglio
surface data from
the scan appliance.
13
Figures 11–13: Models of the patient’s restorative
arch (upper left) and provisional prosthesis (above)
were articulated along with the patient’s bite registration
and a maxillary cast (left) for analysis.
Figure 14: Multi-unit temporary cylinders (shown
here on the mandibular soft tissue model) allowed the
patient’s provisional to function as a fixed prosthesis.
Figure 15: A surgical index was fabricated on the articulated
model between the guide and maxillary cast.
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