Clinical Case Reports Of Digital Implantology And Prosthetics

Objective: This case reports were used the computer-aided design / computer-aided manufacturing(CAD / CAM)technology to production the computer-designed surgical guide template,the custom abutments,the polymethyl methacrylate(PMMA)provisional prosthesis to evaluated CAD / CAM therapeutic effect in implantology and prosthetics.Also comparison the clinical efficacy of three computer-aided design plant software.Materials and methods: Selected 7 cases were by using computer-aided design surgical guide template guided to surgery or production CAD / CAM implant-supported prosthesis,including dentition defect 6 cases(2 cases in anterior,4 cases in posterior)and single edentulous jaw 1 case,from Dalian Stomatological Hospital Implantology Center,from January 2014 to January 2016.Firstly,preoperative need oral examination,shoot a cone beam CT and make treatment plan according the patient situation.Then CT data was imported the computer-aided design software.According to the patient's available bone volume,using the computer-aided design software to visualization implanting,production the CAD/CAM surgical guide template.Implant surgery was performed in the CAD/CAM surgical guide template.After 4-6 months later,the implant had a good osseointegration and implant stability quotient(ISQ)was more than or equal 65.Then,we could make an impression.Then using the CAD/CAM method to creating the custom abutments and the implant-supported screw-retained prosthesis.One case report was consecutive edentulous in anterior maxillary,the patient choose CAD / CAM method to production PMMA provisional prosthesis.One case report was the maxillary edentulous,the patient choose maxillary “All-on-6” in computer-designed surgical guide template,permanent restoration has not been completed,and his permanent prosthesis will be the titanium framework with ornamented Ceramage for implant-supported screw-retained prosthesis.Results: 7 cases were implanted a total of 29 implants that had better implant position.4 cases had placed the permanent prosthesis.During the observation period,radiological examination was that implants had a good osseointegration,peri-implant bone was in a stably level and the prostheses had reached the completely seated position.Case 1 occurred food impaction phenomenon after 6 months in the subsequent visit,then the prosthesis added porcelain in proximal surface to solve the food impaction.Case 3 was in the stage of gingival tissue forming,patient was satisfied for provisional prosthesis.Because of systemic disease and inconvenient to move,case 4 had not subsequent visit.Case 7 was used “All-on-6” completely limiting computeraided design surgical guide template to perform implanting with mild postoperative complications.Conclusion:The computer-designed surgical guide template can improve implant position accuracy,but it has a small amount of deviation.In the computer-aided design processing,we need set a safety distance with the important anatomical structure.According to the patient's condition choose the suitable computer-aided design software.In the selecting the CAD/CAM custom abutments processing,the anterior region should choose the zirconia custom abutments,and the posterior region should choose titanium custom abutments.The CAD/CAM longitudinal screw-retained restorations can reduce adhesive residue,and the restoration has easily removable and repairable.The CAD/CAM occlusal surface of zirconia or metal restorations can increase prosthesis strength and reduce the rate of collapse porcelain.