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Multifunctional Prosthesis as a Surgical Guide Using Digital Jaw Motion in a Fully Digital Workflow for Implant-Supported Complete-Arch Fixed Prostheses
Introduction
Fully digital workflows improve accuracy, reduce chair time, and enhance restorative planning. Simulation of patient-specific mandibular motion is critical for precise design of implant-supported complete-arch fixed dental prostheses (ISCFDPs). Virtual articulators are commonly used for this purpose; however, their accuracy may be limited by assumptions in motion simulation. AI-derived jaw motion offers a promising alternative by capturing patient-specific functional movements. Additionally, integration of prosthesis design as a surgical guide enables precise, prosthetically driven implant placement. This clinical report compares virtual articulator–based simulation and AI-derived jaw motion within a fully digital workflow incorporating a multifunctional prosthesis that functions as both a surgical guide and a restorative appliance.
Method
A 32-year-old male patient presented with partial edentulism and a history of facial bone fractures. A fully digital workflow integrating DICOM and STL datasets was implemented for planning maxillary and mandibular ISCFDPs. Following osseointegration of initially placed implants and bone augmentation procedures, implant positions were captured using the Complete Arch Scanbody Pillar System (CAPS). A virtual articulator was generated by integrating CBCT-derived DICOM data, facial scan records, and intraoral scans to establish the terminal hinge axis and perform a virtual facebow transfer. A Cadiax digital axiograph was utilized to record patient-specific mandibular movements and anatomical parameters, which were incorporated into the virtual articulator.
Esthetic and functional evaluation of the digital tooth arrangement enabled fabrication of a multifunctional prosthesis derived from virtual articulator data. This prosthesis was used to fabricate a surgical guide for prosthetically driven mandibular posterior implant placement and an immediate provisional prosthesis, which required minimal chairside adjustment after delivery.
Three months after provisionalization, the provisional prosthesis was scanned to generate AI-based jaw motion data and update the virtual articulator, allowing direct comparison using patient-specific terminal eccentric movement recordings as reference. The simulated jaw motion data were subsequently incorporated into the workflow for final prosthesis design.
Results
AI analysis of wear pattern areas generated jaw motion based on anterior determinants, while the virtual articulator simulated motion using posterior condylar guidance. Both methods produced similar jaw motion patterns and provided promising results in simulating occlusion and jaw motion digitally and intraorally. The multifunctional prosthesis enabled precise implant placement, ensuring proper alignment and supporting an efficient restorative workflow.
Conclusion: Integrating a multifunctional prosthesis within a fully digital workflow enhances implant placement accuracy, predictability and reduces the need for chairside adjustments.