Digital Impression Taking for Maxillary Full-Arch Restoration With Immediate Loading: A Case Report
The aim of this clinical report is to describe a maxillary full-arch implant supported restoration with immediate loading performed by means of an entirely digital work flow with photogrammetric system and intraoral scanning. A female patient with an edentulous maxillary arch attended the dental clinic seeking a maxillary fixed restoration. After treatment planning, 6 implants were placed using a surgical splint fabricated digitally by intraoral scanning of her previous removable prosthesis. Multiunit abutments were fitted, and 2 digital impressions were taken, one with a photogrammetric system for determining implant positions and the other with an intraoral scanner for soft tissue registration. The acrylic resin structure of the immediate prosthesis was milled and placed within 8 hours of implant surgery. This provisional structure fitted correctly and provided adequate esthetics and function. Radiographic and clinical follow-up after 24 months observed adequate implant evolution.
Figure 1. Intraoral front view of patient before treatment.
Figure 2 . Occlusal view of maxilla.
Digital impressions taken with intraoral scanner. (a) Impression of the alveolar ridge and remaining teeth. (b) Impression with the maxillary acrylic prosthesis. (c) Planning implant positions. (d) Surgical splint.
Flag-shaped markers (PIC abutments) screwed onto implants for impression taking.
Alignment by means of best-fit method of photogrammetric impression and intraoral digital impression. (a) Impression of alveolar ridge. (b) Spatial simulation of implant positions. (c) Designing the prosthesis. (d) Occlusal view of prosthesis and implant emergence.
Milling the polyoxymethylene (POM) structure.
Figure 7. Intraoral frontal view of immediately loaded fixed interim prosthesis.
Figure 8. Occlusal view of immediately loaded interim prosthesis.
Figure 9. Extraoral image with immediate loading.
Diagram illustrating the entire work flow, step-by-step.
Figure 11. Intraoral front view of definitive prosthesis 2 y after placement.
Figure 12. Extraoral image of patient with definitive prosthesis.
Figure 13. Panoramic radiograph after 2-y follow-up.
Contributor Notes