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The field of implant dentistry continues to grow both in terms of the number of practitioners placing and restoring implants and in terms of as well as patient demand for successful outcomes in as short a time as possible. The pace of technological changes and new offerings from implant manufacturers and allied industries are equally fast in their attempts to meet these demands, with a frequently bewildering array of potential solutions available to clinicians. This is never more so than in the field of digital dentistry, with hardware and software solutions for diagnosis, imaging, planning, surgery, impression-taking, and the computer-aided design and manufacture of intraoral prostheses. However, we must always remember our responsibility to ensure that our treatments are carried out safely and in the best interests of our patients. This new Volume 11 of the ITI Treatment Guide series continues the successful theme of the previous ten volumes: a compendium of evidence-based methodology in digital techniques and procedures for daily practice. Written by renowned clinicians and supported by contributions from expert practitioners, the ITI Treatment Guide Digital Workflows in Implant Dentistry provides a comprehensive overview of various technological options and their safe clinical application.
Inserting dental implants to replace missing teeth is a well-established treatment concept. New digital developments are being introduced rapidly and are supposed to improve this already successful treatment modality. These digital techniques should improve predictability, reduce complications and make the treatments more efficient or cost-effective. The aim of this thesis was to evaluate some of these - already commercially available - new digital developments in implantology. The techniques studied in this thesis involve three major steps in this digital workflow. 1. Implant placement using 'static computer guided surgery'. Meaning that the implants are inserted utilizing a drill guide – based on a three-dimensional pre-operative planning – to force the drills and implants in the correct direction. This planning requires the merging two three-dimensional scan files: an x-ray made with a cone beam CT scanner (CBCT) and a surface scan of the remaining teeth and gums made with an intraoral optical scanner (IOS). The merging of these scan files is called superimposing and facilitates the visualization of all important (anatomical) structures, allowing a pre-operative prosthetic- and surgical plan. When the plan is finished a 3D Printer creates a drill guide and the implants are placed accordingly. The prospective clinical trial of this thesis focused on tooth-supported drill guides in partially edentulous patients to replace one, two or three posterior teeth per treated side. 2. When these implants are osseointegrated several months later, these same IOS can be used to register the exact location of these implants. This registration is necessary to create a well-fitting restoration to be fixed on these implants. This IOS is considered a 'digital impression' and can eventually replace conventional impressing techniques using compound-filled impression trays and plaster casts.
Practical Procedures in IMPLANT DENTISTRY Master the fundamentals and intricacies of implant dentistry with this comprehensive and practical new resource Practical Procedures in Implant Dentistry delivers a comprehensive collection of information demonstrating the science and clinical techniques in implant dentistry. Written in a practical and accessible style that outlines the principles and procedures of each technique, the book offers clinical tips and references to build a comprehensive foundation of knowledge in implantology. Written by an international team of contributors with extensive clinical and academic expertise, Practical Procedures in Implant Dentistry covers core topics such as: Rationale and assessment for implant placement and restoration, including the diagnostic records and surgical considerations required for optimal planning and risk management Incision design considerations and flap management, with an essential knowledge of regional neuro-vascular structures Implant placement, encompassing the timing of the placement, bone requirements and understanding the importance of the peri-implant interface for soft tissue stability Impression techniques, loading protocols, digital workflows and the aesthetic considerations of implants Prosthetic rehabilitation of single tooth implants to fully edentulous workflows, including discussions of soft tissue support, biomechanics and occlusal verification Perfect for both general dental practitioners and specialists in implant dentistry, Practical Procedures in Implant Dentistry is also a valuable reference to senior undergraduate and postgraduate dental students.
Digital Workflow in Reconstructive Dentistry is the result of efforts made by the academic team at the Department of Prosthodontics, University Hospital of Freiburg. It aims to build a fundamental understanding of the general principles, science, and clinics of digital dental medicine. The information provided within these pages summarizes the various components of the digital workflow in reconstructive dentistry and discusses their advantages and disadvantages. Moreover, insights are provided about upcoming, game-changing technologies. By reading this book, students, clinicians, and researchers will gain and enhance their knowledge about digital dental medicine and identify the areas they need to focus on next in order to integrate the available technologies in their daily work. Clearly, the path of digital dental medicine will not stop here. Contributors Amirah M. R. Alammar • Abdulaziz Alsahaf • Wael Att • Maria Bateli • Jasmin Bernhart • Shaza Bishti • Sarah Blattner • Miha Brezavšček • Sandy Cepa • Nadine Emmanoulidi • Ahmed Fawzy • Manrique Fonseca • Michele Frapporti • Rumpa Ganguly • Yousef Al-Ghamdi • Petra Ch. Gierthmuehlen • Aiste Gintaute • Ulrich Lamott • Christos Lamprinos • Matthias Petsch • Udo Plaster • Aikaterini Ploumaki • Hanna Rauberger • Elisabeth Schwartzkopff • Christian F. Selz • Thamer Al-Sharif • Benedikt Spies • Frank A. Spitznagel • Jörg R. Strub • Michael Swain • Taskin Tuna • Alexander Vuck • Siegbert Witkowski
This book describes the fusion of CBCT and CAD/CAM technologies for the purpose of surgical dental treatments and explains the advantages and applications of this digital approach for implant placement procedures and other oral surgical protocols. All aspects of computer-aided imaging and design are first covered in the textbook, including the creation of DICOM and STL files; followed by the process of virtual merging to obtain a combined image. Secondly, clinical tips for the use of digital wax up, software interactions and accurate template fabrication are explained, including subtractive and additive methods used for this manufacturing step. The remainder of the book is devoted to the application of technology fusion in implantology, guided bone regeneration, and maxillofacial surgery. Both static and dynamic guided surgeries are described. Materials characteristics and surgical instruments are also presented to define a correct selection criteria. The digital approach outlined in this textbook involves a paradigm shift in the way traditional oral surgery is conceived. Technology fusion aims to improve treatment accuracy, optimize clinical time and reduce patient morbidity. Clinicians will find this book to be a valuable guide for virtual surgical planning and a path to introduce themselves into the exciting world of digital dental surgery.
The trend of digitalization is an omnipresent phenomenon nowadays - in social life and in the dental community. Advancement in digital technology has fostered research into new dental materials for the use of these workflows, particularly in the field of prosthodontics and oral implantology.CAD/CAM-technology has been the game changer for the production of tooth-borne and implant-supported (monolithic) reconstructions: from optical scanning, to on-screen designing, and rapid prototyping using milling or 3D-printing. In this context, the continuous development and speedy progress in digital workflows and dental materials ensure new opportunities in dentistry.The objective of this Special Issue is to provide an update on the current knowledge with state-of-the-art theory and practical information on digital workflows to determine the uptake of technological innovations in dental materials science. In addition, emphasis is placed on identifying future research needs to manage the continuous increase in digitalization in combination with dental materials and to accomplish their clinical translation.This Special Issue welcomes all types of studies and reviews considering the perspectives of the various stakeholders with regard to digital dentistry and dental materials.
This book presents up-to-date information on promising indications for ultrasound in contemporary periodontics and implant therapy with the aim of assisting researchers and dental practitioners to use this novel imaging modality to advance research and patient care. Readers will find clear guidance on the application of ultrasound for evaluation of periodontal and peri-implant tissues. The mechanism of ultrasound imaging is explained in detail and compared to other imaging modalities. Furthermore, the role of ultrasound in the planning and execution of implant surgery and the assessment of implant stability is discussed. The book closes by considering the potential dental applications of functional ultrasound and volumetric ultrasound. This book will potentially be of high values for dental surgeons, periodontists, general dentists, orthodontists, dental hygienists, dental assistants, dental researchers and other practitioners, etc.
TitleDigital Workflow Used to Fabricate Implant-Supported Three-Unit Fixed Dental ProsthesisBackground The use of chair-side oral scanning for multi-unit implant prostheses is still limited, even though an increasing number of dentists are incorporating computer aided design and manufacturing (CAD/CAM) in everyday practice, and the potential for saving precious time and money is enormous. There are coded healing abutments available that allow for intra-oral scanning and a digital prosthetic workflow without first replacing the healing abutments by scanning abutments.Aim/HypothesisBy conducting a study on CAD/CAM 3-unit prostheses, the current state of the digital workflow and the accompanying pitfalls and possibilities are explored, with the expectation that the use of an oral scanner would allow for the fabrication of abutments and bridges with good clinical results.Material and MethodsIn an IRB approved prospective trial, in healthy patients two dental implants (4mm width, length 8.5-15mm) were inserted to replace three missing posterior teeth. After osseointegration, a coded healing abutment was placed, and subsequently full-arch intra-oral scans were made to produce patient specific titanium abutments and a full-zirconia bridge. Clinical variables were measured before treatment, after loading and at one year after loading. Radiographic bone height was measured on radiographs of time of loading and one year after. Patient satisfaction was measured using questionnaires, complications were noted.ResultsAll patients (n=60, mean age 60.8 years [35.7-78.1], 30m/30f) were treated with CAD/CAM abutments and bridges (n=60, 33 maxilla, 27 mandibula); average follow-up was 13 months (range 1-35). One implant was lost before loading. At 1-year (n=28), average radiographic bone loss was 0.04mm and no significant changes in plaque, bleeding, probing pocket depth or gingiva index occurred. Loosening (n=3) and periimplant mucositis (n=2) could be treated. Some scans had to be redone (n=7) and many bridges were rejected (n=20) before delivery because the color did not match. After test-fitting, adjustment of color (n=2), design (n=2) or occlusion (n=2) was performed. Slight adjustment of contact, occlusion or articulation was common (n=35) at cementation. The dentists involved, reported slight color mismatch (43%) and detectable margin discrepancy (5%). Patients were highly satisfied with design (4.3/5), color (4.2/5) and overall treatment result (4.9/10 before, 8.1/10 after treatment).Conclusion and Clinical implicationsThe application of CAD/CAM showed promising results with good clinical results and high patient satisfaction, but the high number of rejections and adjustments would need to be addressed. The shortcomings we encountered in this workflow were mainly due to the laboratory procedures and the restorative materials used. After both the dentist and the dental lab have gained sufficient experience with the digital workflow, it becomes a feasible alternative to the conventional impression workflow. Conflict of interest/AcknowledgementUnrestricted grant for research and material support provided by Zimmer Biomet.
A fully updated second edition of this well-illustrated guide to advanced surgical procedures in periodontology Practical Advanced Periodontal Surgery, Second Edition is a step-by-step guide to cutting-edge surgical techniques and interdisciplinary treatment approaches in periodontology. Written by leading experts in the field, the book provides solutions to complex daily dental challenges with innovative approaches to each treatment modality. Procedures are described in a practical and accessible style, highlighting complex and advanced procedures using a highly illustrated visual format. This expanded edition includes three new chapters that cover IV sedation, digital technologies in clinical restorative dentistry, and advanced implant therapies in the esthetic zone post extraction. Well balanced and solidly grounded in the science, this reference work is an indispensable resource for the practitioner of advanced dentistry. This important guide: • Offers an easy-to-use, practical step-by-step format • Contains clinical photographs that detail the surgical procedures presented • Reviews the most advanced techniques in periodontal surgery and their integration with digital treatment planning and workflow • Discusses the pros and cons for each procedure, as well as limitations and potential complications • Features video clips illustrating key points in the procedures described on a companion website Written for periodontists, periodontal residents and general or restorative dentists, this revised edition of Practical Advanced Periodontal Surgery is a practical and complete clinical manual filled with illustrations for easy reference.