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Anterior implant-supported restorations can be challenging, but for a patient undergoing growth and development changes, clinical resolution becomes complex and demanding. To achieve successful outcomes, multidisciplinary dental therapy is required to manage esthetic consequences while maintaining a minimally invasive approach. This clinical report describes a comprehensive treatment protocol to address and treat growth and development complications for an implant-supported prosthesis. By combining computer-aided design and computer-aided manufacture technology and facially driven procedures, a predictable and favorable outcome was achieved., (Copyright © 2024 Editorial Council for The Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

A novel way to use the patient's existing ceramic crown from a nonrestorable maxillary anterior tooth as part of the interim restoration after extraction is described. The crown was fixed intraorally with a digitally designed and 3D printed resin-bonded fixed dental prosthesis framework in its pre-extraction position. The procedure maintained esthetics, optimized soft-tissue management, and provided a fixed prosthesis before implant placement in the esthetic zone., (Copyright © 2022 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

This article presents a rapid technique for the accurate transfer of implant positions immediately after image-guided surgery to enable the immediate installation of a definitive complete arch implant-supported prosthesis with an implant biological width of 3 mm within 3 appointments. A sleeveless copy of the implant surgical guide is magnetically connected to a reference guide to ensure the accurate capture of cylindrical titanium transfer abutments. In the laboratory, the sleeveless guide with the splinted transfer abutments attached is used to generate a definitive cast to be scanned with a desktop scanner. The resulting digital definitive cast is then combined with the original meshes of the prosthetically driven virtual treatment plan to enable a definitive computer-aided design and computer-aided manufactured prosthesis to be fabricated and installed with passive fit., (Copyright © 2022 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

This technique enables the establishment of an accurate reciprocation distance to resist undesirable forces on abutments and ensure the parallelism of removable partial denture placement on the guide template by using computer-aided design and computer-aided manufacture techniques and to ensure accurate abutment preparation., (Copyright © 2022 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Statement of Problem: Despite studies focusing on the accuracy and dimensional stability of additive manufacturing, research on the impact of storage conditions on these properties of 3-dimensional (3D) printed objects is lacking., Purpose: The purpose of this in vitro study was to investigate the influence of storage temperature on the dimensional stability of digital light processing (DLP) printed casts and to determine how different locations in printed casts react differently., Material and Methods: A completely dentate maxillary typodont model was digitized with a desktop laser scanner. The typodont was subsequently modified with a software program by adding cuboids with a side length of 3 mm on both maxillary central incisors, first molars, and second molars. The file was saved in the standard tessellation language (STL) format. The modified digitized typodont was then processed through the DLP technology printing process with a desktop DLP printer and photopolymerizing resin. The casts were printed 32 times and stored in sealed plastic bags, shielded from light, and subjected to 4 different temperature conditions (-20 °C, 4 °C, 20 °C, and 37 °C, n=8 each). The cuboids on the central incisors were labeled as the P1 group, first molars as the P2 group, and second molars as the P3 group. The distance between the cuboids was measured 5 times, with results recorded immediately after cast production and at 1, 2, 3, 5, 7, 14, and 28 days after. Repeated analysis of variance (ANOVA) and the Tukey honestly significant difference (HSD) test were used to compare the recorded values among the groups (α=.05)., Results: In the P1 group, the casts stored at -20 °C exhibited the smallest overall size change, with a mean ±standard deviation volume of 99.42 ±0.04% compared with the original casts after 28 days of storage. This was followed by the casts stored at 4 °C, 20 °C, and 37 °C, with remaining volumes of 99.39 ±0.06% (P=.139), 99.14 ±0.08% (P<.001), and 98.96 ±0.03% (P<.001), respectively. For the P2 and P3 groups, casts stored at 4 °C retained the most volume at 99.82 ±0.01%, whereas those stored at -20 °C, 20 °C, and 37 °C underwent greater changes, with remaining volumes of 99.66 ±0.03%, 100.32 ±0.02%, and 100.44 ±0.02%, respectively (P<.001). The P3 group exhibited a similar trend to that of the P2 group, with the casts stored at 4 °C remaining closest to the original dimensions at 99.86 ±0.02%, while casts stored at -20 °C showed 99.73 ±0.03% of the original volume and those stored at 20 °C and 37 °C expanded with volumes of 100.37 ±0.03% and 100.48 ±0.03%, respectively (P<.001)., Conclusions: DLP printed casts stored at 4 °C exhibited the greatest overall dimensional stability, followed sequentially by those stored at -20 °C, 20 °C, and 37 °C. Additionally, the study confirmed that the posterior and anterior teeth regions of DLP printed casts respond differently to different storage temperatures., Competing Interests: Declaration of Competing Interest None., (Copyright © 2024 Editorial Council for The Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

A digital dental technique is described for registering functional borders of immediate complete dentures, by using an intraoral scanner, a dental computer-aided design software program, and a peripheral custom tray. This article also illustrates how to virtually match the recorded information in order to transform the initial intraoral scan into definitive digital scans., (Copyright © 2020 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

This clinical report described a digital workflow for the design, manufacture, and clinical delivery of a polyetherketoneketone (PEKK) removable dental prosthesis with a speech bulb. The process combined intraoral scanning, digital milling for the PEKK framework, and 3D printing for the definitive cast., (Copyright © 2019 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Statement of Problem: Clinical trials are needed to evaluate the digital and conventional fabrication technology for providing fixed partial dentures (FPDs)., Purpose: The purpose of the second part of this clinical study was to compare the laboratory production time for tooth-supported, 3-unit FPDs by means of computer-aided design and computer-aided manufacturing (CAD-CAM) systems and a conventional workflow. In addition, the quality of the 3-unit framework of each treatment group was evaluated clinically., Material and Methods: For each of 10 participants, a 3-unit FPD was fabricated. Zirconia was used as the framework material in the CAD-CAM systems and included Lava C.O.S. CAD software (3M) and centralized CAM (group L); CARES CAD software (Institut Straumann AG) and centralized CAM (group iT); and CEREC Connect CAD software (Dentsply Sirona) and centralized CAM (group C). The noble metal framework in the conventional workflow (group K) was fabricated by means of the traditional lost-wax technique. All frameworks were evaluated clinically before veneering. The time for the fabrication of the cast, the 3-unit framework, and the veneering process was recorded. In addition, chairside time during the clinical appointment for the evaluation of the framework was recorded. The paired Wilcoxon test together with appropriate Bonferroni correction was applied to detect differences among treatment groups (α=.05)., Results: The total effective working time (mean ±standard deviation) for the dental technician was 220 ±29 minutes in group L, 217 ±23 minutes in group iT, 262 ±22 minutes in group C, and 370 ±34 minutes in group K. The dental technician spent significantly more time in the conventional workflow than in the digital workflow, independent of the CAD-CAM systems used (P<.001)., Conclusions: Irrespective of the CAD-CAM system, the overall laboratory time for the dental technician was significantly less for a digital workflow than for the conventional workflow., (Copyright © 2018 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Statement of Problem: Clinical trials are needed to evaluate digital and conventional technologies for providing fixed partial dentures., Purpose: The purpose of the first part of this clinical study was to test whether complete-arch digital scans were similar to or better than complete-arch conventional impressions regarding time efficiency and participant and clinician perceptions., Material and Methods: Ten participants in need of a posterior tooth-supported 3-unit fixed partial denture were included. Three intraoral digital scanners and subsequent workflows (Lava C.O.S.; 3M [Lava], iTero; Align Technology Inc [iTero], Cerec Bluecam; Dentsply Sirona [Cerec]) were compared with the conventional impression method using polyether (Permadyne; 3M) and the conventional workflow. A computer-generated randomization list was used to determine the sequence of the tested impression procedures for each participant. The time needed for the impression procedures, including the occlusal registration, was assessed. In addition, the participant and clinician perceptions of the comfort and difficulty of the impression were rated by means of visual analog scales. Data were analyzed with the nonparametric paired Wilcoxon test together with an appropriate Bonferroni correction to detect differences among the impression systems (α=.05)., Results: The total time for the complete-arch impressions, including the preparation (powdering) and the occlusal registration, was shorter for the conventional impression than for the digital scans (Lava 1091 ±523 seconds, iTero 1313 ±418 seconds, Cerec 1702 ±558 seconds, conventional 658 ±181 seconds). The difference was statistically significant for 2 of the 3 digital scanners (iTero P=.001, Cerec P<.001). The clinicians preferred the conventional impression to the digital scans. Of the scanning systems, the system without the need for powdering was preferred to the systems with powdering. No impression method was clearly preferred over others by the participants., Conclusions: For complete-arch impressions, the conventional impression procedures were objectively less time consuming and subjectively preferred by both clinicians and participants over digital scan procedures., (Copyright © 2018 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

To evaluate the occlusion accuracy of a novel impression technique, excessively high occlusion and the occlusal contact area during lateral movements were compared between metal restorations (restorations) and removable partial dentures (RPDs) fabricated using conventional and novel techniques. Both restorations and RPDs were fabricated on the simulation model with the precise displacement of the remaining teeth and soft tissue. For the novel technique, functionally generated path (FGP) recording and impression under occlusal force were simultaneously performed using a custom tray with an FGP table. For the two conventional techniques, definitive casts were mounted on an average value articulator and a semi-adjustable articulator in the typical manner. Prostheses were placed on the simulation models, and excessively high occlusion in the intercuspal position and occlusal contact areas during lateral movements were measured. Statistical analyses were performed using Kruskal-Wallis and Steel-Dwass tests (α = 0.05). For both prostheses, conventional techniques showed significantly higher occlusion in the intercuspal position than the novel technique. Moreover, the new technique demonstrated better guidance contact during lateral movements than conventional techniques. This novel technique can be recommended for the fabrication of highly accurate prostheses with appropriate occlusal contact without corrections at delivery.

Statement of Problem: Titanium frameworks for implant-supported prostheses can be additively manufactured using different powder-based fusion technologies, including selective laser melting (SLM) and electron beam melting (EBM). Some manufacturers have developed a technique that combines the printing of the framework with the subsequent machining of the implant interface. Whether these technologies produce frameworks with acceptable accuracies is unclear., Purpose: The purpose of this in vitro study was to evaluate the discrepancy obtained from the digitizing procedures of the definitive cast, the implant-prosthesis discrepancy, and the distortion of the manufacturing processes in the fabrication of titanium frameworks for implant-supported complete-arch prostheses manufactured using SLM and EBM additive manufacturing technologies., Material and Methods: A completely edentulous mandibular definitive cast with 4 implant analogs and a replica of a screw-retained interim restoration was obtained. A standard tessellation language (STL) file of the framework design was prepared using dental software (Exocad). Six frameworks were manufactured using either SLM (3D Systems) or EBM (Arcam) technologies. Discrepancy (μm) was measured at the x- (mesiodistal), y- (buccolingual), and z- (occlusogingival) axes by using the formula 3D=x 2 +y 2 +z 2 three times by best-fit superimposure of the definitive cast STL file, the definitive cast titanium framework, and the framework STL file by using a coordinate measuring machine (CMM) controlled by software (Geomagic). The Kruskal-Wallis and Mann-Whitney U statistical tests were used (α=.05)., Results: The digitizing procedures of the definitive cast showed a mean accuracy of 3 ±3 μm. Except for the z-axis (P<.05), no significant differences were observed between the SLM and EBM technologies for implant prosthesis discrepancy for the x- or y-axis (P>.05). The most favorable results were obtained in the z-axis, representing the occlusogingival direction. Three-dimensional discrepancy measurements in all comparisons ranged between (60 ±18 μm and 69 ±30 μm) and were not statistically significant (P>.05). The highest discrepancy was observed in the y-axis (37 to 56 μm), followed by the x- (16 to 44 μm) and z- (6 to 11 μm) axes (P<.05)., Conclusions: The titanium frameworks analyzed for a complete-arch implant-supported prosthesis fabricated using either the SLM or EBM additive technologies showed a clinically acceptable implant-prosthesis discrepancy, where similar discrepancies on the x-, y-, and z-axes were found between the additive manufacturing technologies. Both technologies showed comparable abilities to manufacture the STL file additively on the x-, y-, and z-axes., (Copyright © 2018 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Statement of Problem: The color of resin cements and computer-aided-design and computer-aided-manufacturing (CAD-CAM) restorations may change with aging., Purpose: The purpose of this in vitro study was to analyze the influence of thermocycling on the color of CAD-CAM materials with underlying resin cement., Material and Methods: Seven different CAD-CAM materials, composite resins and glass-ceramics were cut into 0.7-mm and 1.2-mm thicknesses (n=10) and cemented with a dual-polymerizing resin cement, a light-polymerizing resin cement, and a preheated composite resin (N=420). Color values were measured by using spectrophotometry. Specimens were subjected to thermocycling (5°C and 55°C; 5000 cycles). The measured color difference (ΔE) data were analyzed by using descriptive statistics. Normality of data distribution was tested by using the Kolmogorov-Smirnov test. Three-way and 1-way ANOVA followed by the Scheffé post hoc test and unpaired 2-sample Student t test were computed to determine the significant differences among the tested parameters (α=.05)., Results: ΔE values were significantly influenced by the CAD-CAM material (η p 2 =0.85, P<.001) and the resin composite cement (η P 2 =0.03, P=.003) but were not influenced by thickness (P=.179). Significant interactions were present among thickness, cement, and CAD-CAM materials (P<.001). Vita Suprinity and GC Cerasmart showed significantly the lowest ΔE values (P<.001). The highest ΔE values were observed for IPS Empress CAD. The dual-polymerizing resin cement showed significantly lower ΔE values than the preheated composite resin (P=.003)., Conclusions: Restoration materials and composite resin cement types used for cementation influence the amount of color change due to aging., (Copyright © 2017 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Statement of Problem: The use of resin patterns to produce partial coverage restorations is poorly documented., Purpose: The purpose of this in vitro study was to compare the marginal and internal fit accuracy of lithium disilicate glass-ceramic inlays obtained from wax or resin patterns and fabricated with digital and conventional techniques., Material and Methods: A dentoform mandibular first molar was prepared for a mesio-occlusal ceramic inlay. Six groups of 15 inlays were obtained by conventional impression and manual wax (group CICW) or resin patterns (group CICR); conventional impression, laboratory scanning of the stone die, CAD-CAM milled wax (group CIDW), or polymethylmethacrylate (PMMA) blocks (group CIDR); and scanning of the master preparation with an intraoral scanner, CAD-CAM milled wax (group DSDW), or PMMA blocks (DSDR). The same design was applied to produce the wax and PMMA patterns in the last 4 groups. The replica technique was used to measure marginal and internal fit under stereomicroscopy. Mixed-model ANOVA was applied to assess differences according to the techniques, materials, and discrepancy location (α=.05)., Results: The results demonstrated significant effects of the technique (P<.001), material (P=.009), and discrepancy location (P<.001) on fit measurements. Marginal discrepancy was only affected by the technique (P<.001), with the digital approaches yielding the smallest marginal discrepancy (23.5 ±3.6 μm), followed by the conventional digital techniques (31.1 ±5.6 μm) and finally by the conventional (42.8 ±7.2 μm) techniques. Internal fit was significantly influenced only by the material with lower discrepancy in wax (75.2 ±9.0 μm) than in resin patterns (84.7 ±15.1 μm). The internal discrepancy was significantly larger than the marginal discrepancy in all groups (P<.001)., Conclusions: Inlays generated from conventional wax and resin patterns tend to show higher marginal discrepancies than conventional digital and full digital patterns. Wax and resin materials yield similar marginal fit accuracies irrespective of the impression/manufacturing technique. Better internal fit was shown in wax than in resin patterns, regardless of the technique., (Copyright © 2018 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Purpose: With computer-aided design and computer-aided manufacturing (CAD/CAM), the study was conducted to create a removable partial denture (RPD) framework using repeated laser sintering rather than milling and casting techniques. This study experimentally evaluated the CAM clasp and compared it to a conventional cast clasp., Methods: After the tooth die was scanned, an Akers clasp was designed using CAD with and without 50μm of digital relief on the occlusal surface of the tooth die. Cobalt-chromium (Co-Cr) alloy clasps were fabricated using repeated laser sintering (RLS) and milling as one process simultaneously (hybrid manufacturing; HM). The surface roughness of the rest region, gap distances between clasp and tooth die, initial retentive forces, and changes of retentive forces up to 10,000 insertion/removal cycles were measured before and after heat treatment. The HM clasp was compared to the cast clasp and the clasp made by repeated laser sintering only without a milling process., Results: The HM clasp surface was smoother than those of cast and RLS clasps. With the digital relief, the fitness accuracy of the HM clasp improved. The retentive forces of the HM clasps with relief and after heat treatment were significantly greater than for the cast clasp. HM clasps demonstrated a constant or slight decrease of retention up to 10,000 cycles., Conclusions: HM clasp exhibited better fitness accuracy and retentive forces. The possibility of clinically using HM clasps as well as conventional cast clasps can be suggested., (Copyright © 2018 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.)

This clinical report describes the management of a patient who had a metal allergy and had difficulty sitting in a dental chair for an extended period. The presented treatment used an intraoral scanner and computer-aided design and computer-aided manufacturing (CAD-CAM) to fabricate a nonmetal clasp denture. The described procedure may reduce patient discomfort and chair-time., (Copyright © 2017 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Statement of Problem: The subtractive and additive computer-aided design and computer-aided manufacturing (CAD-CAM) of lithium disilicate partial coverage restorations is poorly documented., Purpose: The purpose of this in vitro study was to compare the marginal and internal fit accuracy of lithium disilicate glass-ceramic inlays fabricated with conventional, milled, and 3-dimensional (3D) printed wax patterns., Material and Methods: A dentoform mandibular first molar was prepared for a mesio-occlusal ceramic inlay. Five groups of 15 inlays were obtained through conventional impression and manual wax pattern (group CICW); conventional impression, laboratory scanning of the stone die, CAD-CAM milled wax blanks (group CIDW) or 3D printed wax patterns (group CI3DW); and scanning of the master preparation with intraoral scanner and CAD-CAM milled (group DSDW) or 3D printed wax patterns (group DS3DW). The same design was used to produce the wax patterns in the last 4 groups. The replica technique was used to measure marginal and internal adaptation by using stereomicroscopy. Mixed-model ANOVA was used to assess differences according to the groups and discrepancy location (α=.05)., Results: Group DSDW showed the smallest marginal discrepancy (24.3 μm) compared with those of groups CICW (45.1 μm), CIDW (33.7 μm), CI3DW (39.8 μm), and DS3DW (39.7 μm) (P<.001). No statistically significant differences were detected among groups CICW, CIDW, CI3DW, and DS3DW relative to the marginal discrepancy. The internal discrepancy was significantly larger than the marginal discrepancy within all groups (P<.001)., Conclusions: Lithium disilicate glass-ceramic inlays produced from digital scans and subtractive milling of wax patterns resulted in better marginal and internal fit accuracy than either conventional impression/fabrication or additive 3D manufacturing. Three-dimensional printed wax patterns yielded fit values similar to those of the conventionally waxed inlays., (Copyright © 2017 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

A digital technique is presented that records peri-implant soft tissue contours and the emergence profile. The architecture of interim restorations and adjacent teeth, the position of the implant, and the emergence profile of interim prostheses are scanned and registered to design a zirconia frame and to form a digital cast., (Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Statement of Problem: Clinical studies are needed to evaluate the entire digital and conventional workflows in prosthetic dentistry., Purpose: The purpose of the second part of this clinical study was to compare the laboratory production time for tooth-supported single crowns made with 4 different digital workflows and 1 conventional workflow and to compare these crowns clinically., Material and Methods: For each of 10 participants, a monolithic crown was fabricated in lithium disilicate-reinforced glass ceramic (IPS e.max CAD). The computer-aided design and computer-aided manufacturing (CAD-CAM) systems were Lava C.O.S. CAD software and centralized CAM (group L), Cares CAD software and centralized CAM (group iT), Cerec Connect CAD software and lab side CAM (group CiL), and Cerec Connect CAD software with centralized CAM (group CiD). The conventional fabrication (group K) included a wax pattern of the crown and heat pressing according to the lost-wax technique (IPS e.max Press). The time for the fabrication of the casts and the crowns was recorded. Subsequently, the crowns were clinically evaluated and the corresponding treatment times were recorded. The Paired Wilcoxon test with the Bonferroni correction was applied to detect differences among treatment groups (α=.05)., Results: The total mean (±standard deviation) active working time for the dental technician was 88 ±6 minutes in group L, 74 ±12 minutes in group iT, 74 ±5 minutes in group CiL, 92 ±8 minutes in group CiD, and 148 ±11 minutes in group K. The dental technician spent significantly more working time for the conventional workflow than for the digital workflows (P<.001). No statistically significant differences were found between group L and group CiD or between group iT and group CiL. No statistical differences in time for the clinical evaluation were found among groups, indicating similar outcomes (P>.05)., Conclusions: Irrespective of the CAD-CAM system, the overall laboratory working time for a digital workflow was significantly shorter than for the conventional workflow, since the dental technician needed less active working time., (Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Patients with CHARGE syndrome (where CHARGE stands for coloboma of the iris or retina, heart defects or cardiac malformations, atresia/stenosis of the choanae, retardation of growth and development, genital anomalies, and ear abnormalities) present several orofacial anomalies. Their treatment depends on the specific type of manifestation. To perform the complex oral rehabilitation and achieve a conservative, esthetic, and functional exploration of the definitive treatment goal, computer-aided design and computer-aided manufacturing (CAD-CAM) polymers can be used as long-term interim restorations. This article reports the treatment of a young patient with CHARGE syndrome combined with oral alterations. CAD-CAM polymers offer an intermediate treatment with satisfying esthetics and function at low biological cost until bone growth is completed. This period facilitates additional planning for the definitive restoration., (Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

This article describes a method that incorporates the solid modeling CAD software Solidworks with a dental milling machine to fabricate individual abutments in house. This process involves creating an implant library with 3-dimensional (3D) models and manufacturing a base, scan element, abutment, and crown anatomy. The 3D models can be imported into any dental computer-aided design and computer-aided (CAD-CAM) manufacturing system. This platform increases abutment design flexibility, as the base and scan elements can be designed to fit several shapes as needed to meet clinical requirements., (Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

The difficulty of retrieving the abutment screw is a major disadvantage of cement-retained implant restorations. Conventional methods for locating the screw-access hole are based largely on radiography or manual labor, which limits accuracy and clinical feasibility. This clinical report describes a non-radiological method for fabricating an accurate drilling guide for location of the screw channel using intraoral optical scanning, 3D superimposition, and computer-aided design and computer-aided manufacturing (CAD/CAM) technologies. The present technique not only improves the guide fabrication process and the accuracy of screw-channel drilling, but also has wide indications for implant restorations., (© 2016 by the American College of Prosthodontists.)

Statement of Problem: Trials comparing the overall performance of fully digital and conventional workflows in reconstructive dentistry are needed., Purpose: The purpose of the first part of this randomized controlled clinical trial was to determine whether optical impressions produce different results from conventional impressions with respect to time efficiency and patient and operator perceptions of the clinical workflow., Material and Methods: Three digital impressions and 1 conventional impression were made in each of 10 participants according to a randomly generated sequence. The digital systems were Lava COS, iTero, and Cerec Bluecam. The conventional impression was made with the closed-mouth technique and polyvinyl siloxane material. The time needed for powdering, impressions, and interocclusal record was recorded. Patient and clinician perceptions of the procedures were rated by means of visual analog scales. The paired t test with Bonferroni correction was applied to detect differences (α=.05/6=.0083)., Results: The mean total working time ±standard deviation amounted to 260 ±66 seconds for the conventional impression, 493 ±193 seconds for Lava, 372 ±126 seconds for iTero, and 357 ±55 seconds for Cerec. The total working time for the conventional impression was significantly lower than that for Lava and Cerec. With regard to the working time without powdering, the differences between the methods were not statistically significant. The patient rating (very uncomfortable=0; comfortable=100) measured 61 ±34 for conventional impression, 71 ±18 for Lava, 66 ±20 for iTero, and 48 ±18 for Cerec. The differences were not statistically significant. The clinician rating (simple=0; very difficult=100) was 13 ±13 for the conventional impression, 54 ±27 for Lava, 22 ±11 for iTero, and 36 ±23 for Cerec. The differences between the conventional impression and Lava and between iTero and Lava were statistically significant., Conclusions: The conventional impression was more time-effective than the digital impressions. In terms of patient comfort, no differences were found between the conventional and the digital techniques. With respect to the clinician perception of difficulty, the conventional impression and the digital impression with iTero revealed more favorable outcomes than the digital impression with Lava., (Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

The inclusion of computer-aided design/computer-aided manufacturing (CAD/CAM) technology into complete denture fabrication facilitates the procedures. The presented workflow for complete denture fabrication combines conventional and digitally supported treatment steps for improving dental care. With the presented technique, the registration of the occlusal plane, the determination of the ideal lip support, and the verification of the maxillomandibular relationship record are considered., (Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

A digital process is presented for an implant-supported single-tooth and a 3-unit fixed dental prosthesis (FDP) with customized abutments and monolithic prosthetic zirconia restorations. The digital impression on the implant level was made with a TRIOS intraoral scanner (3Shape). This process included the fabrication of an implant cast with the fused deposition modeling technique and a 3-dimensional printing process with integrated implant analogs. The process enabled the FDPs to be designed with CAD/CAM on the cast before patient contact. Designing a printed implant cast expands the use of the digital workflow in the dental field., (Copyright © 2015 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

This clinical report describes the treatment of maxillary and mandibular immediate implant placement and immediately loaded implant-supported interim complete fixed dental prostheses with a contemporary digital approach. The virtual diagnostic tooth arrangement eliminated the need for a customized radiographic template, and the diagnostic data collection required for computer-guided surgery (digital diagnostic impressions, digital photographs, and a cone beam-computed tomography [CBCT] scan) was completed in a single visit with improved workflow efficiency. Computer-aided design and computer-aided manufacturing (CAD/CAM)-fabricated surgical templates and interim prosthesis templates were made in a dental laboratory to facilitate computer-guided surgery and the immediate loading process., (Copyright © 2015 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Well-placed dental implants are a prerequisite of functional and esthetically successful dental implant-supported crowns. The presence of soft tissue is essential for excellent esthetics because the dental implant or titanium abutment may become visible if the soft-tissue contour is not acceptable. This clinical report describes the use of a custom ceramic implant abutment designed with computer-aided design and computer-aided manufacturing (CAD/CAM) technology by milling a zirconia framework that was cemented extraorally to a prefabricated titanium abutment with a reduced diameter. This ceramic abutment has the strength and precise fit of a titanium interface and also the esthetic advantages of shaded custom-milled zirconia, with no visible metal., (Copyright © 2014 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)