•This technique is suitable for a patient with an existing full arch provisional prosthesis supported by few natural abutments and satisfying functional and esthetic requirements.

•Clinical verification ensures restoration fit, occlusion, incisal edge position, and esthetics (Figure 1).

•A pickup Impression of the provisional prosthesis with an elastomeric impression material, polyvinylsiloxane in this case, is poured using a non-compatible elastomeric impression material, polyether in this case, for the prepared teeth and surrounding soft tissue and type IV dental stone for the rest of the model.

• This results in a model that accommodates provisional seating and removal without damaging the model (Figure 2).

• The creation of a radiographic guide involves the use of light-cured composite tray material (Triad) to add flanges to the provisional prosthesis and the strategic placement of radiopaque markers (gutta percha) (Figure 3).

•Key steps include identifying the smile line and marking it with a pencil intraorally, as well as positioning the radiopaque markers along the smile line (Figure 4).

•Dual CBCT scans are conducted: one with the patient wearing the radiographic guide and another focusing solely on the guide (Figure 5).

 

The merging of the two CBCT DICOM files occurs within implant planning software (DTX Studio Implant) using radiopaque markers, which then serve as the foundation for implant planning guided by the provisional teeth position. The results underscore the successful alignment of radiographic data with the patient's provisional teeth position, culminating in the precise fabrication of a prosthetically driven surgical guide (Figure 6).

This technique offers a solution to the challenge of merging a patient's radiolucent provisional fixed restoration with CBCT scans. By fostering accurate registration and minimizing chair time, radiation exposure, and costs, this noninvasive method holds immense promise in achieving meticulous implant planning and surgical guide fabrication, thereby advancing the realm of implant dentistry.