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Combined Analog and Digital Workflow for an Implant Supported Rehabilitation, Case Report


Saad AlResayes, BDS, MS

Duaij Alazemi, BDS

Aristotelis Marinis, DDS, DMD, MS

Jaime Lozada, DMD – Professor and Director, Loma Linda Implant department


Purpose of the Study: The purpose of this clinical presentation is to illustrate the systematic pretreatment evaluation of an edentulous patient and to demonstrate the integrated analog and digital workflow for the restorative and surgical planning.

Methods: This presentation illustrates the technique of comprehensive implant dentistry planning through integration analog and digital workflow. The technique includes clinical treatment using non-restrictive guided surgery, and the fabrication of a final restoration with Zirconia material. The presentation also showing the procedure of fabricating custom implant abutments utilizing CAD/CAM methods. 48-year-old female patient presented with a chief complaint of: “ My upper denture is not stable and I can’t live with it anymore.” • Diagnosis: • Maxillary complete edentulism • Mandibular partial edentulism • PDI Class IV • Adequate bone quality and restorative space for a maxillary implant-supported full arch fixed zirconia prosthesis and a mandibular segmented fixed zirconia prosthesis.

Results: • Patient was rehabilitated by 4 dental implants in the maxillary arch and 6 dental implants in the mandibular arch. • Surgical procedure was completed utilizing analog and digital workflow by duplicating the dentures and marking the implant position according to the restoratively driven 3D virtual planning on Simplant software (Dentsply Sirona). • Treatment Workflow: - Esthetic Analysis - Diagnostic Wax-Up - Dual Scan / CBCT - Image Merging - 3D Surgical Planning - Provisional Fabrication - Surgical Guide Fabrication - Implant Placement - Prosthesis Conversion - Conventional Implant loading - Final Prosthesis Fabrication

Conclusion: Virtual implant planning and restoratively driven therapy play an important role for optimal success and favorable outcomes. It provides predictable esthetic, functional, and patient dependent treatment from the controlled 3D implant location to final prostheses.

Articles: D'haese J, Ackhurst J, Wismeijer D, De Bruyn H, Tahmaseb A. Current state of the art of computer-guided implant surgery. Periodontol 2000. 2017 Feb;73(1):121-133 Bedrossian E, Sullivan RM, For1n Y, Malo P, Indresano T. Fixed-prosthe1c implant restora1on of the edentulous maxilla: a systema1c pretreatment evalua1on method. J Oral Maxillofac Surg. 2008 Jan;66(1):112-22

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