The fully digital workflow has been a subject of discussion and debate within the dental industry for years. Today, thanks to the development of cutting-edge technologies, it is finally possible to approach this working methodology in order to allow the clinician, dental technician and most importantly the patient, to rely on a predictable treatment, thus allowing a reduction in time and costs.
Within this workflow, the role of the 3D printer assumes a considerable importance, both for the production of classic artifacts such as models, gingiva, surgical guides and temporary elements. It also offers the option of adopting alternative approaches and creating, for example, aesthetic and functional wax-ups. This solution, on one hand, allows the dental technician and clinician to instantly check the matching between what has been digitally designed and what has been created, and on the other hand it facilitates the patient in a clear understanding of the final result. This process allows the professional to adopt an approach that takes into great consideration not only the clinical and functional side, but also the psychological impact marked by such an important treatment in case of rehabilitation of total edentulism.
The clinical case here below fits precisely within this context: a full rehabilitation of the superior arch that is approached in a totally digital way with the aid of radiographic images (CBCT), used to obtain the data necessary for implant planning, of .stl files, acquired through intraoral scanning, and photographic images that are used for the design of the final prosthesis and the smile design, respectively.
After acquiring the necessary clinical data, performing the implant planning and the subsequent surgery, we proceeded to design the final prosthesis consisting of a bar screwed onto implants (made by CNC) and its counterbar with an abutment structure (made using laser metal fusion 3D printing technology), which subsequently allows to design and cement each dental element as a single piece, an approach that allows greater versatility and easier maintenance over time.
Before proceeding with the production of the final counterbar, the files relating to the counterbar and the individual elements are “merged” into a single .stl file that is printed in EVERES TEMPORARY resin using EVERES UNO. The accuracy and the speed of the printer allows the creation of an aesthetic wax-up in an extremely short time, perfectly matching dimensionally and geometrically to what have been previously designed using the software. This allows the team, made up of clinician and dental technician, to present the final result to the patient with an extremely effective approach, without the need of modified images displayed on the screen.
This approach makes it possible to verify the matching between what has been designed and what was built before proceeding with the production of the final prosthesis, allowing for changes and corrections, without incurring into further costs or time lengthening and also reduces the number of required sessions for the patient.
From this clinical case it is clear how a professional-level 3D printer allows, in addition to the creation of classic artifacts such as models, gingiva, surgical guides and temporary elements, an ability to approach important treatments in a totally innovative way. It is aimed at reducing time and number of appointments needed for the completion of the treatment itself. 3D printing allows the introduction of a simplified protocol both in terms of flexibility and in terms of changes and variations allowed with zero impact.
About Simone Fedi
Simone Fedi graduated with 60/60 in dental technology in 1997, at the I.P.S.I.A. Gaslini in Genova. In 2003 he joined the company of his current laboratory. He specialized first in total prosthesis, following courses on the Gerber and Passamonti method, then he specialized in the technique of reverse layering in composite following courses in Bredent and casting using traditional techniques.
In October 2015 he won the competition organized by Trasformer system with a protocol on injection prostheses. Expert in cad-cam techniques in fixed and removable prosthesis solutions.
- Spectrum dialogue – Vol. 15 No. 8: A Simplified Dental Protocol For the construction of Implant/Mucosal support removable prosthesis
- Mesiecznik Lekarzy Stomatologow (Poland) – 9/2016: Protezy:funkcja, estetyka, higiena
- Cosmetic Dentistry – Ottobre 2016: Protesi rimovibile: igiene, funzione, estetica.
- Dental Dialogue – Anno XXIV 2017 n°1: Protocollo odontotecnico semplificato per la realizzazione di una protesi rimovibile a supporto implantare/mucoso.
- European Journal of Dentistry – Agosto 2020: FEM Analysis Applied to OT Bridge with Seeger Retention System