Digital workflow for implant-supported fixed complete dentures based on backwards planning in an edentulous patient

Aim: This case report describes a digital workflow for prosthetically driven surgical planning, implant placement, and the fabrication of two screw-retained, complete-arch, implant-supported dentures in an edentulous patient. The purpose of this case report is to present and discuss the digital steps in the workflow, especially the scanning technique to obtain the centric relation, through a clinical case. The limitations of the workflow are also discussed.
Materials and methods: Static computer-aided implant surgery (s-CAIS) was planned three-dimensionally, based on cone beam computed tomography, intraoral optical scanning, and digital bite registration. Using s-CAIS, four and six implants were placed in the edentulous mandible and maxilla, respectively. The final screw-retained complete-arch monolithic zirconia restorations were manufactured based on a digital workflow, using the pre-existing modified radiologic guide for the digital maxillomandibular record.
Conclusions: The evolution of digital processing methods allows for design, processing, and fabrication of implant-supported fixed complete dentures using a surgical, prosthetic, and technical workflow based on 3D restorative backward planning. A digital prosthetic setup and CAD/CAM can be used for the fabrication of intraoral try-ins that serve as a model for the final monolithic zirconia superstructure. Keywords: backward planning, edentulous, complete-arch, implant-supported, fixed complete denture, CAD/CAM, monolithic zirconia, radiologic guide