Marco Tallarico^1,*; Erta Xhanari²; Roberto Scrascia^3,*; Łuksaz Zadrożny⁴

¹School of Dentistry, University of Sassari, Sassari, Italy; ²Aldent University, Tirana, Albania; ³University of Foggia, Foggia, Italy; ⁴University of Warsaw, Warsaw, Poland

Background: Integrated treatment planning with dental implants is a well-established option. Nevertheless, the achievement of the optimal implant position, based on the prosthetic plan, is still critical and unknown protocols in implant-based surgery and prosthesis.

Aim/Hypothesis: To present several innovation in the treatment of complete edentulous patients, using a fully digital workflow, including a new assembled surgical template; a specially customized impression tray; and a new concept for definitive impression using scan analogs and extra-oral impression.

Material and Methods: This study was designed as proof of concept, aimed to tune further studies with larger sample size and follow-up. Five patients were treated using computer/assisted, template-based surgery. All the patients were treated with four implants, immediate loading, and definitive complete arch restoration. Multi-piece surgical templates were used both for implant placement and immediate loading procedure. This surgical template is featured with two to three assembled parts that allow for safe implant placement and immediate loading delivery even in case bone reduction is needed. After osseointegration period, definitive extra-oral digital impressions were taken using a specially customized prosthetic template (impression tray) that allow for accurate impression and cross mounting. New scan analogs were connect in the patient mouth using temporary cylinder and stabilized by means of low-shrinkage, flowable, resin composite.

Results: All the implants osseointegrated without any problem. All except one impression were judge accurate, evaluating the fit with the radiograph test (Sheffield test). On the other hands, one impression was redone due to inaccuracy of the aluminium tray-in. Finally all the patients were completely satisfied of both surgical and prosthetic procedures.

Conclusion and Clinical implications: Within the limitations of this study, multi-piece surgical template showed promising results improving the clinicians confidence in case of bone reduction, post-extractive implants, and immediate loading. The prosthetic template increased the trueness of the digital impression for complete edentulous patient. Scan analog used for extra-oral chair side digital impression showed promising results. Further study are needed to confirm these preliminary results.

Disclosure of Interest: None Declared

Keywords: digital workflow, guided implant surgery, intraoral scanner

马可·塔拉里科^1,* ; Erta Xhanari ² ; 罗伯托·斯克拉夏^3,* ; Łuksaz Zadrożny ⁴

¹意大利萨萨里萨萨里大学牙科学院；²奥尔登特大学，阿尔巴尼亚地拉那；³福贾大学，意大利福贾；⁴华沙大学，华沙，波兰

背景：牙种植体的综合治疗计划是一个成熟的选择。尽管如此，根据假体计划实现最佳种植体位置仍然是基于种植体的手术和假体的关键和未知协议。

目的/假设：使用全数字化工作流程，包括新组装的手术模板，展示治疗完全缺牙患者的多项创新；一个特别定制的印模托盘；以及使用扫描类似物和口外印象确定印象的新概念。

材料与方法：本研究旨在作为概念证明，旨在调整具有更大样本量和后续行动的进一步研究。五名患者使用计算机/辅助的、基于模板的手术进行治疗。所有患者均接受了四颗种植体、即刻负重和最终完全牙弓修复的治疗。多片式手术模板用于种植体植入和即刻装载程序。该手术模板具有两到三个组装部件，即使在需要减少骨量的情况下，也可以安全放置植入物并立即提供负重。骨整合期后，使用专门定制的假体模板（印模托盘）进行最终的口腔外数字印模，该模板允许准确印模和交叉安装。

结果：所有种植体骨整合无任何问题。除了一个印象外，所有的都被判断为准确，通过射线照相测试（谢菲尔德测试）评估适合性。另一方面，由于铝托盘的不准确，一个印象被重做。最后，所有患者对手术和假肢手术均完全满意。

结论和临床意义：在本研究的局限性内，多片式手术模板显示出有希望的结果，提高了临床医生对骨质减少、拔除后植入物和即刻负重的信心。修复模板提高了全缺牙患者数字印模的真实性。用于口腔外椅侧数字印模的扫描模拟显示出有希望的结果。需要进一步研究来证实这些初步结果。

利益披露：无申报

关键词：数字化工作流程，引导种植手术，口内扫描仪