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Advancements in CAD-CAM technology have allowed for a variety of options in implant-supported fixed prosthesis restorations for completely edentulous patients. For patients with severe alveolar bone resorption, zirconia prosthetic restorations that include the gingival portion, such as implant-supported hybrid dentures, are possible, as well as monolithic zirconia prosthetic restorations in the form of crowns. The integration of digital technology in fixed prosthetic restoration using implants enables predictable treatment through diagnosis and virtual surgery by integrating the patient's clinical and radiological information. In this case, the utilization of digital software allowed for the establishment of implants in appropriate positions, considering both the remaining alveolar bone and the final prosthesis. By designing both the maxillary removable prosthesis and the mandibular fixed prosthesis simultaneously in CAD software, bilateral balanced occlusion could be easily achieved. Furthermore, maintaining the initial interocclusal relationship from provisional restorations to final prostheses allowed for convenient transition while ensuring functional and aesthetic satisfaction. [ABSTRACT FROM AUTHOR]

With the increasing use of CAD-CAM (computer-aided design-computer-aided manufacturing) methods for prosthesis fabrication, utilization of virtual articulators in CAD software has also increased. Among the various methods of positioning the maxilla in a virtual articulator, there are techniques that utilize CBCT (cone-beam computed tomography) or facial scans without the use of a facebow. In this case, a full-mouth rehabilitation was planned for a patient who exhibited multiple crown fractures and occlusal plane disharmony through maxillary complete denture and mandibular fixed prosthetic restoration. Radiopaque markers were added to the duplicated maxillary temporary denture to take closed-mouth impression, which was then scanned and positioned on the CBCT. On CBCT, hinge axis connecting the medial poles of both mandibular condyles along with the Frankfort horizontal plane was designated and utilized to perform virtual articulator mounting. Maxillary complete denture and mandibular fixed prostheses were fabricated, resulting in satisfactory aesthetic and functional outcomes. [ABSTRACT FROM AUTHOR]

In patients with unstable mandibular movements who are accompanied by involuntary facial muscle movements and asymmetrical changes in the facial features, many difficulties exist in determining the vertical dimension of occlusion, recording centric relation, and transferring information about the occlusal plane. In this case, for a patient with unilateral facial nerve palsy who was edentulous for a long period of time, a CAD-CAM provisional prosthesis was fabricated using a 3D printing customized gothic arch tracer and a prefabricated occlusal plane recorder, the POP bow system, to achieve a stable interarch relationship. Afterwards, a full mouth implant fixed prosthesis was fabricated by delivering an appropriate vertical dimension of occlusion, a reproducible centric relation, and a correct three-dimensional occlusal plane, and continuous maintenance was performed to restore functional and aesthetic oral health to the patient. [ABSTRACT FROM AUTHOR]

Removable partial denture wearers are exposed to the risks that remaining teeth get damaged by caries, attritions, erosion, and fracture. In the case of damaged abutment tooth which should fit to Removable partial denture (RPD), the fabrication of surveyed crown is followed by the making of RPD. However, making new denture takes a long time, and needs several processes and costs. Also, patients should get used to new denture. If other abutment teeth and edentulous ridges provide the existing denture with support, retention, and stability, use of existing denture is considered clinically acceptable. In this situation, fabricating retrofit crowns to an existing removable partial denture makes patient use existing denture, cuts costs, and reduces discomfort. In this case, severely worn teeth were restored using monolithic zirconia crown which fit to an existing removable partial denture by CAD-CAM. Moreover, support, retention, and stability of the denture were improved, and both doctor and patient were satisfied with the result. [ABSTRACT FROM AUTHOR]

In the case of fully edentulous patients with severe alveolar bone resorption, the consideration of ‘All-on-X’ implant-supported fixed prosthesis after placing four or more implants in the anterior maxilla is possible. Recent advancements in digital dentistry have enabled systematic and predictable treatment in all phases, including diagnosis, surgery, and prosthesis fabrication. By incorporating digital dentistry techniques such as digital complete denture, implant surgical guides, facial scanning into the conventional restoration process, it is possible to reduce the complexity of the prosthesis fabrication and effectively achieve the transition from provisional prosthesis to definitive prosthesis in terms of both aesthetics and function. [ABSTRACT FROM AUTHOR]

Implant overdentures are widely used as a treatment method to restore oral function in completely edentulous or partially edentulous patients with severe bone resorption. Using a milled bar, it is mechanically advantageous as the implant fixtures are splinted. Applying additional attachments to the bar has the advantage of dispersing the stress applied to the implant. In this case, a patient who used implant overdentures using 4 implants wanted to fabricate a new prosthesis due to repeated fractures of the denture and weakened retention. Milled bar with ADDTOC attachment and zirconia prosthesis were fabricated by CAD-CAM method and mechanically and aesthetically satisfactory results were obtained. [ABSTRACT FROM AUTHOR]

There are various approaches to treatment for patients with fully edentulous jaw. In maxilla, it is easy to obtain sufficient stability, support, and retention with the traditional full denture method. In mandible, however, there are difficulties caused by anatomical limitations. In this case, treatment with implants can be considered. If it is difficult to place implants in posterior area, a fixed complete denture can be considered, using 4 - 5 implants anterior to mental foramen. This approach has changed in many ways, such as surgical methods and materials used, over the years. This case report compares two approaches and their changes over time, especially in the cases of mandibular fixed prostheses using implants, paired with maxillary complete denture. [ABSTRACT FROM AUTHOR]

This case report introduces a 74-year-old male patient who visited retention deficiency of the mandibular implant overdenture, which was fabricated 20 years ago. When the existing dentures were used, the vertical dimension was reduced, the maxillary complete denture lacked lip support and retention, and the mandibular overdenture lacked clip retention due to damage to the bar attachment. After removing the damaged bar attachment, it was replaced with a ball attachment, and impressions were taken using the DENTCATM Tray and then the vertical dimension was measured. The gothic arch tracing was performed to record the centric relation. Obtained impressions were scanned and the shape of final dentures was designed using software and try-in dentures were fabricated using 3D printer. After evaluating the occlusal plane, occlusal relationship, facial shape, and pronunciation using the try-in dentures, the bite registration was recorded, and the final denture was manufactured based on this. The inner surface of the denture was adjusted and bilateral balanced occlusion was formed, and the housing was connected to the mandibular denture by a direct method. This case reports have shown satisfactory resultin recovering improved retention and esthetic outcome by increasing the vertical dimension and the lip support using CAD-CAM technique and the ball attachment. [ABSTRACT FROM AUTHOR]

For treatment of partially edentulous patients, a treatment using implant is widely used. Treatment method using implant are implant fixed prostheses and removable partial dentures, and for patients with severe bone resorption, removable implant overdenture with the effects of aesthetic and reducing cost can be used as treatment options. Specially, prosthesis with milled-bar and attachment has the effect of being splinted between implant fixtures, higher retention and stability than conventional removable partial denture. And it has the effect of improvement of aesthetic through lip support by denture base. In this case, the patient with severe alveolar bone resorption and partial edentulous maxilla and mandible was treated by implant-assisted removable partial denture using Milled-bar and ADD-TOC attachment. The esthetic was improved by removing the clasp because of effects of additional retention by using the attachment, and reducing palatal coverage of implant-assisted removable partial denture. The clinical results were satisfactory on the aspect of aesthetic and masticatory function. [ABSTRACT FROM AUTHOR]

For a full-mouth fixed prosthetic treatment of the edentulous patient, it is essential to confirm the proper tooth position and thorough evaluation of the remaining alveolar bone and soft tissue before surgery. CAD-CAM dentistry and guided implant surgery have such advantages of providing simultaneous planning of surgery and prosthetic treatment to ensure pre-knowledge of the treatment. In this clinical case, using the digital technology, digital temporary denture fabrication, esthetic evaluation before fixed prostheses treatment, and guided surgery planning was possible. After the surgery, previously obtained data was used for fabricating fixed temporary prostheses. Definitive zirconia prostheses transferred from the provisional prostheses were fabricated and functionally and esthetically satisfying results were obtained. [ABSTRACT FROM AUTHOR]

Complete dentures are one of the most basic treatment methods for the treatment of edentulous patients. The manufacturing process of traditional complete dentures goes through the steps of taking primary impressions, secondary impressions, jaw relation record, trying in wax denture, and final denture insertion. Multiple visits and complex manufacturing procedures are required, and errors may occur in each step. With the development of digital technology, manufacturing steps have been reduced by introducing digital technology to the denture treatment process. In the process of manufacturing dentures by introducing a digital process, a more precise work is possible using Computer-Aided Design, and it is possible to shorten the period of labor and reduce the number of visits. In this case, the anterior teeth arrangement of the patient’s existing dentures was transferred to the final dentures using a digital method. After taking impression, try-in dentures were digitally fabricated and tried in the oral cavity to evaluate their retention in the oral cavity. Final dentures were manufactured by milling process. The number of visits was reduced, satisfactory retention and stability of dentures were obtained, and aesthetic recovery was achieved. [ABSTRACT FROM AUTHOR]

This report demonstrates a method of generating a chair-side and computer-aided template for implant surgery based on the Top-Down and restoration-driven concept. Compared to the traditional CAD-CAM process which requires multiple steps to be taken between dental clinic and laboratory, this alternative procedure, VARO guide system (VARO Guide, CAD, Pre-Guide, VARO-mill, NeoBiotech, Seoul, South Korea) enables accurate and patient-friendly implant surgery as well as immediate provisional restoration in a single visit. First, bite-registration at centric jaw relation and CBCT were taken using the Pre-Guide. The CBCT data was then reorganized directly through the chair-side CAD, and we could determine the most appropriate 3-dimensional position of implant. The STL file was extracted and put into the chair-side CAM (VARO-mill) to fabricate a VARO. This surgical guide allowed the implants to be accurately positioned into the planned sites within an hour. [ABSTRACT FROM AUTHOR]

Purpose. The purpose of present study was to evaluate the effect of changing structural stability of wax disc on the fit of prosthesis when the milling proceeded in order. Materials and methods. Prepared maxillary left first molar was used to fabricate a Ni-Cr alloy reference model. This was scanned to design crown and then wax pattern was milled, invested and cast to fabricate prosthesis. The wax patterns located in a row centrally within a single wax disc were set into a total of five groups ranging from WM1 group that was first milled to WM5 group that was last milled and the number of each group was set as 10. Silicone replica technique was used to measure the marginal gap, axial internal gap, line angle internal gap, occlusal internal gap. Data was evaluated with one-way ANOVA with significance level set at α = .05 and then Tukey HSD test was conducted for post analysis. Results. Marginal gap measured in each group, it was 40.41 ± 2.15 μm in WM1 group, 40.44 ± 2.23 μm in WM2 group, 39.96 ± 2.25 μm in WM3 group, 39.96 ± 2.48 μm in WM4 group, and 40.57 ± 2.53 μm in WM5 group. No significant difference was found between groups. The significant difference between the groups was also not found in the axial internal gap, line angle internal gap, and occlusal internal gap. Conclusion. Internal and marginal fit of single crown to the sequential order of milling processing in the single machinable wax disc did not seem to be affected by the sequence. [ABSTRACT FROM AUTHOR]

Purpose. The purpose of this study was to evaluate the currently published literatures investigating the accuracy of computer-aided design and computer-aided manufacturing removable partial denture (CAD-CAM RPD) framework with different manufacturing techniques and methods. Materials and methods. A comprehensive search for literatures was conducted in PubMed database using specific keywords with the patient, intervention, comparison, and outcome (PICO) question, "Is there a difference in accuracy of RPD frameworks manufactured using digital workflow according to the manufacturing process and methods?" Results. A total of 7 articles were selected. Two studies compared intraoral scanning and laboratory scanning for RPD frameworks and had heterogenous results. In the studies using different manufacturing process, RPD frameworks had clinically acceptable accuracy in both subtractive and additive manufacturing. Polyetheretherketone (PEEK)-milled RPD frameworks showed higher fit accuracy than traditionally casted or 3D printed RPDs. Direct milling method showed a higher accuracy than indirect milling method. However, in rapid prototyping, indirect method showed higher accuracy than direct method. Conclusion. The RPD frameworks fabricated using CAD-CAM technology showed a clinically acceptable level of accuracy regardless of manufacturing process or techniques. Consistent results have not been reported regarding the digital impression methods, which were intra oral scanning or laboratory scanning, and further studies are needed. [ABSTRACT FROM AUTHOR]

The evaluation of occlusion using digital methods is easier and simpler in terms of recording, comparison, analysis, and objectivity compared to existing methods such as articulating paper and occlusion foil. The purpose of this case report was utilizing the digital method for evaluating occlusion. The occlusion of patient requiring full veneer crown restoration was evaluated using an intraoral scanner (i500, Medit, Seoul, Korea) at every visit. The occlusion was also assessed using conventional articulating paper and a digital occlusal analysis system (Dental prescale II, GC corp., Tokyo, Japan) for comparison. Throughout the treatment process, the intraoral scanner and the conventional articulating paper method showed similar outcomes. The results suggest that the use of digital evaluation system is highly probable in the near future. [ABSTRACT FROM AUTHOR]

This report describes the prosthetic treatment of a patient with multiple missing teeth. Installation of five fixtures on maxilla with sinus lift and six fixtures on mandible with ramal bone graft were performed. With implant supported all-ceramic with zirconia core using CAD/CAM technology and porcelain-fused-to-gold prosthesis, treatment with positive outcome which satisfies both functional and esthetical aspect was obtained. [ABSTRACT FROM AUTHOR]

Comprehensive prosthetic treatment requires considerations from various points of view. The anterior guidance is important factor in prosthodontic treatment of anterior teeth. Lingual surface contour of anterior restoration is so critical that a small mistake of laboratory or clinical process can cause discomfort of patient and disharmony of entire dentition. There are no guidelines for lingual surface contour that fit all patients. Therefore the lingual surface of provisional restoration is most accurately described as a customized one. The dentist transfers the exact information of anterior guidance that has made through long term provisional restoration to the technician. This case introduce that the duplication technique of CAD/CAM system to reproduce the anterior guidance of provisional restoration. This method can improve satisfaction of both patient and dentist. [ABSTRACT FROM AUTHOR]