Clinical case
Digital flow in unitary dental implants rehabilitation in anterior sector. Surgical and prosthetic planning. Case report
Aim: The purpose of this article is to present a clinical case of high aesthetic demand. Such planning and treat with digital flow, included diagnosis, prosthetic planning and finally, the placement of the final prosthesis.
Case report: A 52-year-old woman presents a fracture of the tooth 2.1. After diagnosis and analysis both clinically and radiographically, an impossible restorative prognosis is determined for 2.1, planning implant-supported rehabilitation as treatment. A scan of the area to be treated was carried out to carry out a detailed study of the case and the preparation of a provisional crown, which was screwed at the same time of surgery to an implant placed immediately post-extraction. Besides, hard and soft tissue graft were placed to guarantee the maintenance of the peri-implant contours. After the implant osteointegration, the contour of the provisional crown was scanned to obtain a suitable emergence profile and gingival tissue volume. Both the emergency profile obtained and the contour of the provisional were scanned together with the position of the implant for the preparation of the final metalceramic restoration. After six months, it can observe an ideal soft tissue aesthetic and perfect maintenance of the entire gingival architecture.
Conclusion: The management of the anterior superior aesthetic sector shows a clear aesthetic demand. In cases of tooth loss at this location, fixed implant rehabilitation is the treatment of choice. However, to achieve an adequate and predictable result, proper surgical and prosthetic management is essential. Digital flow it present like alternative and a quality leap in the therapeutic approach to these cases, a more accurate and individualized treatment, and the information that is transferred to the prosthetic laboratory is more simple and efficient.
After the loss of a tooth, a series of physiological processes takes place throughout the dento-alveolar complex that culminates in atrophy and collapse of both the bone and gum tissues, with a horizontal and vertical component. This can have a significant repercussion aesthetically for patients when it affects the anterosuperior aesthetic sector1-. Following advances in rehabilitation of osseointegrated implants (OII), aimed at achieving greater primary stability in post-extraction sockets and allowing a reduction in integration times, new treatment protocols have emerged that can focus rehabilitation on aesthetic sectors much more efficiently. These protocols are based mainly on immediate placement of the screw-retained provisional crowns at the same time during surgery. This allows for the preservation and management of soft and hard tissue grafts and emergency profiles; thus preventing their collapse and giving the patient immediate aesthetic benefit4-6.
Nowadays, digital workflow is increasingly integrating itself in practically all dentistry fields, although its application in oral rehabilitation and cosmetic dentistry is especially important. Implants can be planned following advances in technologies and the use of intraoral scanners and software programs. These digital programs can be used to design the case by computer, analyse the patient photographic study and make virtual study models to improve case planning; thus reducing treatment times and, in the long run, their costs, with respect to traditional methods7, 8.
Digital planning as part of implant rehabilitation is a tool for optimising results and improving surgical planning, which is prosthetically guided from the outset and can lead to more exact handling of peri-implant tissues, thanks to scanning the emergence profiles obtained, and making definitive restorations of great aesthetic quality7, 8.
The objective of this article is to describe the rehabilitation on implants in a high aesthetic demand case, with the treatment based entirely on digital planning.
