Aim: The purpose of this case reportis to illustrate step by step the management of replacing multiple adjacent missing teeth in the esthetic zone using digital workflow. The digital workflow featured digital implant planning and guided implant placement, followed by digital impression and CAD/CAM prosthodontics.
Material and methods: A 30-year-old male patient presented for treatment after missing #7,8,9,10 due to trauma. After the comprehensive exam CBCT and an intraoral scan were done. Digital planning was followed by guided surgery and two implants were placed on the areas of #7,10. After confirming the osseointegration of the implant, a fixed interim implant supported prosthesis (#7-10) was used. Soft tissue conditioning was done with fixed dental prosthesis for period of 2 months. Digital impression was taken with TRIOS scanner and physical cast was fabricated with 3-D printing. The final rehabilitation consisted of implant level screw-retained fixed dental prosthesis(FDP) of monolithic zirconia with minimal facial porcelain veneeringsupported by implants on the areas #7 and #10 fabricated on the printed cast.
Results: This prosthetic treatment option solved esthetic and restorative problems arising from maxillary missing anterior teeth in the esthetic zone. Pink porcelain was used as a nonsurgical option of hard and soft tissue replacement that provided lip support, restored symmetrical gingival architecture, and esthetically replaced papillae. The resulting prosthesis achieved the esthetic expectations of this patient, with a complete digital workflow.
Conclusion: Digital implant planning and monolithic zirconia with minimal facial porcelain veneering implant supported prostheses can give an excellent functional and esthetic outcome. The patient was satisfied with the esthetic result and was enrolled on a 6-month recall program.
Keywords: Dental digital technology, dental implants, fixed provisionalization, papilla, pink porcelain