Photogrammetric and Intraoral Digital Impression Technique for the Rehabilitation of Multiple Unfavorably Positioned Dental Implants: A Clinical Report
The aim of this clinical report is to describe the use of the photogrammetric system and intraoral scanning as a reliable technique to record the 3-dimensional implant positions of a full-arch maxillary implant–supported fixed rehabilitation in which the implants were unfavorably positioned. The stereo camera of the photogrammetric system was used to capture the 3-dimensional panoramic position of the implants. The information on soft tissues was obtained with an intraoral scanner. Then, the 2 digital files (standard tessellation language [STL] files) were subsequently superimposed using a best-fit alignment function to generate the definitive digital model with information on teeth, soft tissues, and implants.

Figure 1. (a) Pretreatment extraoral view of smile. (b) Generalized mucositis around dental implants. Figure 2. Panoramic radiograph after the placement of the posterior implants.

Figure 3. (a) PiC abutments devices on implants. (b) Digital impression of the patient's soft tissues. (c) Virtual image of the implant positions (PiC file) aligned with the digital intraoral impression of the soft tissues using best fit (Exocad). (d) Digital impression of the antagonist arch. Figure 4. Polymethylmethacrylate try-in denture. Figure 5. Virtual image of the metal framework design.

Figure 6. (a) Detail of the screw access channels. (b) Pink composite plugs. (c) Frontal view of the definitive fixed implant-supported prosthesis. Figure 7. (a) Evaluation at 1 year. (b) Panoramic radiograph at 1 year.
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