Preserving Identity in the Transition to Edentulism:
A Personalized Digital Workflow for Immediate and Definitive Single Arch Implant Overdentures
Selina Guo, DMD, Nupur Patel, BDS, DMD, MS, FACP
University of Pennsylvania School of Dental Medicine, Philadelphia, Pennsylvania, United States

Introduction

This case report describes a digital workflow for transitioning a patient with
terminal maxillary dentition to an implant-retained overdenture while preserving his
natural smile.

A 62-year-old male presented with Grade III mobility of maxillary anterior teeth and
loss of posterior support. An open-window impression was made, the cast digitized,
and a custom tooth library created from his dentition. He elected extraction of the
remaining teeth and rehabilitation with an implant-retained overdenture, with the
goal of preserving esthetics while ensuring predictable and efficient treatment.

An immediate denture was fabricated using reference from existing dentition to
guide alveoplasty and implant planning. After healing, the definitive overdenture was
delivered in two visits, ensuring efficiency, esthetic continuity, and patient
satisfaction.

 

Case Report

Data Collection and Digital Custom Tooth Library
• An open-window impression technique was used to achieve border molding without
dislodging compromised teeth.
• The master cast was digitized, and a custom tooth library was created from the patient’s
existing dentition.
• A frontal portrait photo served as a reference for facially generated treatment planning.
This setup guided immediate denture fabrication, alveoplasty, and implant planning.
(Figure 1)

Implant placement and Preprosthetic Surgery and Immediate Denture Delivery
• Extraction of #6-11 and immediate Denture Delivery
• Pilot guided Implant placement, bilateral crestal sinus lift and alveoplasty

Rehabilitation
• Locator selection and insertion
• Close mouth wash impression with Immediate Denture Duplicate
• IROD Delivery and Chairside Pick Up

Conclusions

This case demonstrates how a personalized digital workflow can simplify the
transition from terminal dentition to an implant-retained overdenture. Using an
open-window impression and a custom digital tooth library, the patient’s natural
esthetics were preserved while ensuring functional predictability as well as
predictable surgical planning. A two-appointment protocol reduced chair time and
improved efficiency, while digital replication of the dentition maintained the
patient’s esthetic identity through edentulism.