Table of Contents

1 Introduction
1.1 Acquiring Digital Data
1.2 Manipulating Digital Data

2 Surface Scans

2.1 Introduction

2.2 Analog Impressions
2.2.1 Material Accuracy
2.2.2 Patient Comfort
2.2.3 Cast Production

2.3 Digital “Impressions”—Digitization of the Oral Cavity
2.3.1 File Formats
2.3.2 Extraoral Scanning Systems
2.3.3 Impression Scanning
2.3.4 Intraoral Scanning Systems
2.3.5 Emergence-Profile Scans

2.4 Accuracy: Trueness and Precision
2.4.1 Technique Selection

2.5 The Need for Physical Models

2.6 Concluding Remarks

3 Facial Scanning

3.1 Technological Evolution
3.2 Technological Principles of Contemporary Facial Scanning
3.3 Applications in Prosthetic Dentistry
3.4 Clinical Case
3.5 Dynamic Facial Scanners
3.6 Shortcomings and Future Technical Improvements
3.7 Conclusions

4 Software Packages

4.1 Diagnostics and Data Collection

4.2 Prosthetic and Surgical Planning
4.2.1 Stock Tooth Shapes
4.2.2 Custom CAD
4.2.3 Importing a Clinical Tooth Position from a Diagnostic Set-Up

4.3 Computer-Assisted Design (CAD)
4.3.1 Final Prosthetic Design
4.3.2 Model-Building

4.4 Computer-Assisted Manufacturing (CAM)

4.5 Concluding Remarks

5 Merging Digital Datasets

5.1 Scanning Technologies and Related Datasets
5.2 Accuracy of CBCT Scans
5.3 Field of View (FoV)
5.4 Beam Hardening and Scatter
5.5 Preparation a Patient for a CBCT Scan

5.6 Merging Files
5.6.1 Merging Datasets Using Common Anatomical Structures ..
5.6.2 Merging Additional STL Files
5.6.3 Merging Datasets Using Radiographic Markers

6 Digital Workflows in Implant Prosthodontics

6.1 Digital Workflows Applied to Patient Care
6.2 Diagnostic Steps of the Digital Workflow
6.3 Planning Steps of the Digital Workflow
6.4 Surgical Steps of the Digital Workflow
6.5 Prosthodontic Steps of the Digital Workflow
6.6 Alternative Steps in Digital Workflows

7 Computer-Guided Surgery

7.1 Terminology

7.2 Systems Used in Guided Surgery
7.2.1 Dynamic Systems: Navigated Surgery
7.2.2 Static Systems: Guided Surgery
7.2.3 System Precision

7.3 Positioning the Surgical Guide
7.3.1 Bone-Supported Surgical Guides
7.3.2 Tooth-Supported Surgical Guides
7.3.3 Mucosa-Supported Surgical Guides
7.3.4 Fixture-Supported Surgical Guides

7.4 Prefabrication of Prostheses and Immediate Loading
7.5 Limitations
7.6 Future Developments

8 CAD/CAM Technology and Custom Bone Grafts

8.1 Milled Bone-Graft Materials
8.2 Printed Bone-Graft Materials
8.3 Full 3D Planning of Free Vascularized Fibula Flaps for Maxillofacial Defects

9 Digital Articulators

9.1 Introduction
9.2 Mechanical Articulators

9.3 Digital Articulators
9.3.1 Mechanical Articulation with a Digital Interface
9.3.2 Simple Digital Articulation
9.3.3 Virtual Articulators

9.4 Possible Future Developments

10 Fabrication Techniques and Materials

10.1 Fabrication Techniques and Restorative Materials

10.2 Metal Alloys
10.2.1 Material Selection at the Abutment Level
10.2.2 Material Selection at the Framework Level

10.3 Zirconia
10.3.1 Material Selection at the Abutment Level
10.3.2 Material Selection at the Framework Level
10.4 Lithium Disilicate

11 Complications and Technical Challenges

11.1 Scanning-Related Complications
11.2 Software-Integration Complications
11.3 Milling Complications

12 Future Developments and Challenges


13 Clinical Case Presentations: Implant-Supported Restorations. Using Guided Surgery and CAD/CAM in a Digital Workflow

13.1 Replacing a Mandibular Second Premolar with a Chairside-Fabricated Crown
13.2 Replacing a Mandibular First Molar with a Crown Following Soft-Tissue Modeling
13.3 Immediate Loading of a Premolar Implant with a Provisional Restoration
13.4 Replacing a Mandibular Second Premolar with a Chairside-Fabricated Crown
13.5 Replacing Four Upper Incisors with a Screw-Retained Bridge on Two Implants
13.6 Replacing Three Mandibular Posterior Teeth with an Immediately Loaded Fixed Dental Prosthesis
13.7 Replacing a Mandibular Denture with a Full-Arch Implant-Supported Mandibular Fixed Dental Prosthesis
13.8 Rehabilitating an Edentulous Maxilla with Three Separate Bridges
13.9 Rehabilitating an Edentulous Maxilla with a Fixed Dental Prosthesis Following Provisional Immediate Loading
13.10 Oral Rehabilitation Aided by Digital Dentistry: Immediate Functional Loading with a Prefabricated Provisional Restoration
13.11 Rehabilitating an Edentulous Maxilla with a Conventional Removable Denture and an Edentulous Mandible with a Fixed Dental Prosthesis Using s-CAIS
13.12 Rehabilitating an Edentulous Maxilla with a Fixed Dental Prosthesis Using a DSD-Guided Approach
13.13 Rehabilitating a Maxillo facial Defect with Transplanted Free Vascularized Fibula Segments and a Full-Arch Fixed Dental Prosthesis

14 Technical and Clinical Recommendations


15 References

 

ITI International Team for Implantology
ITI Headquarters
Peter Merian-Strasse 88
4052 Basel
Switzerland

Phone +41 61 270 83 83
Fax +41 61 270 83 84
E-Mail headquarters@iti.org 

ITI International Team for Implantology | Peter Merian-Strasse 88 | 4052 Basel | Switzerland | Phone +41 61 270 83 83 | Fax +41 61 270 83 84 | headquarters@iti.org

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