Achieving an accurate fit in a complete arch screw-retained implant prosthesis is paramount, regardless of whether analog or digital impressions are employed. In the context of complete arch implant prostheses, using intraoral scanners has sparked significant debate. However, recent advancements in scanner technology, specialized scan gauges meticulously calibrated for precise recording, and the implementation of appropriate scanning techniques have substantially improved the precision and accuracy of digital records. The Nexus iOS scan gauge system represents a pioneering approach, seamlessly integrating these optimization strategies into a purely digital workflow to fabricate complete arch screw-retained implant prostheses in edentulous patients. This case report elucidates the fabrication process of a complete arch screw-retained implant prosthesis that exhibited remarkable fitting accuracy and streamlined the treatment process to a mere 3 appointments. The patient reported high satisfaction with the efficient timeline, aesthetic appeal, and functional performance of the prosthesis. A distinctive advantage of this technique is the notable reduction in treatment steps compared to traditional procedures.

Immediate full-arch loading is a highly complex and technique-sensitive procedure. Digital impression techniques aim to replace conventional analog systems to carry out dental treatments in a more predictive, safer, and less time-consuming way. This case report describes a patient with a guarded periodontal prognosis, who was rehabilitated with implant-supported fixed prostheses after full-mouth extractions. Immediate full-arch loading was performed by means of two digital impression systems: photogrammetric technology with PIC dental in the maxillary arch, and MedicalFit in the mandible. Immediate provisional prostheses in acrylic resin (polymethyl methacrylate) were milled and placed within 12 hours after implant placement surgeries. Both provisional structures fitted properly providing adequate esthetics and function. After the implant osseointegration period, final digital impressions were registered, and definitive zirconia full-arch implant-supported prostheses were delivered. The 24-month follow-up did not show biologic or mechanical complications.

Bone resorption following tooth loss is an obvious, continuous, and unpredictable process, which poses one of the greatest challenges in implant placement. The posterior regions of the jaws show more resorption compared to the anterior regions, with the mandible being affected more. Augmentation of the narrow alveolar ridge has been done using various techniques. The alveolar ridge split technique (ARST) is frequently used for the horizontal augmentation of the narrow ridge. In this case report, a 47-year-old female patient who had partial edentulism on the lower left jaw region associated with a narrow alveolar ridge was treated using the ridge split technique. A piezosurgical unit was used for splitting the ridge, followed by simultaneous implant placement. This alveolar ridge split technique is considered to be more predictable, reliable, and successful as compared to other techniques such as autogenous onlay bone graft and guided bone regeneration.

Digital impressions improve patient experience and compliance. Digital impressions enable dental offices to collaborate and work with distant dental laboratories and specialists with ease. Although the initial cost of acquiring an intraoral scanner is significant, its use has the potential to reduce the cost per procedure.

The use of digital tools offers a new perspective to daily clinical activities even though sometimes different clinical approaches are necessary. This case report of a maxillary anterior rehabilitation demonstrates the application of a gingival displacement technique to enhance the recording of subgingival finish line by means of an intraoral optical scanner (IOS). The temporary restoration was used as a guide for the radiosurgery tip in order to displace the gingiva in a guided and mini-invasive approach. It was then possible to create the space between the tooth structure and the soft tissues for the light beam of the IOS to properly detect the finish lines of the dental preparation. Six single porcelain fused to zirconia crowns were delivered. This technique could be considered as a solution of complex cases with subgingival dental preparation to be detected by means of an IOS.

The aim of this study is to present a clinical case of a full arch prosthetic rehabilitation on natural teeth, combining both digital work-flow and monolithic zirconia.
Digital impression was taken with an intraoral optical scanner (CS3500, Carestream Dental, Atlanta, GA, USA). A prosthetic rehabilitation was realized on natural teeth using monolithic zirconia from 1.6 to 1.4 and from 2.7 to 2.4 frameworks, while in the aesthetic area (from 2.3 to 1.3), technicians left on the structure a 0.8 mm vestibular space for ceramic layering.
The combination of digital impression technology and the use of the monolithic zirconia had demonstrated the delivery of the final prosthetic device in a quick time without the need to remodel functional or aesthetic areas. The digital work-flow combines intraoral optical impression techniques and CAD/CAM technology, in order to achieve a fully digital and successful way to deliver prosthetic restorations to patients, providing aesthetics and function in shorter intervals of time. The clinical outcome of this study was satisfactory but a long-term evaluation is needed.

METHODS: A 60-year-old man presented for refabrication of his maxillary complete denture. In this case, a digital process was chosen to replace the ill-fitted complete maxillary denture. A specialized scan retractor was used to retract the mobile tissues of the lips, cheeks and vestibule while taking a digital impression. The interocclusal record obtained in the patient\'s mouth was scanned in order to digitally register the occlusal vertical dimension. The denture base and teeth were designed on virtual models that were mounted at the occlusal vertical dimension, and were made using CAD/CAM technology.
CONCLUSIONS: Unlike conventional impression techniques, intraoral scanning is not able to be performed while the tissue is moving. This case report used a scan retractor that facilitated stretching and fixation of the vestibular area. It also helped to retract the lips and cheeks. This report also demonstrates that virtual models at OVD can be obtained without the use of conventional stone models, flasking or processing techniques. One of the main shortcomings in the existing CAD/CAM denture fabrication technology is that it is not able to produce customized denture teeth. The present article demonstrates that the digital denture fabrication workflow can provide customized denture teeth to optimize occlusion.
CONCLUSIONS: This case demonstrated how digital complete dentures can be made without requiring conventional stone models or mounting the models in an articulator.

OBJECTIVE: The aim of the present study was to describe a proof of concept digital workflow for the implant-prosthetic treatment in partially edentate patients and evaluate its clinical performance.
METHODS: A 55-year-old woman with a Kennedy class III bilateral edentulism in the mandible has been selected for a computer guided implantology according with the Smart Fusion® protocol (NobelBiocare, Kloten, Switzerland). After the template-guided implant placement, an immediate loading of the implants has been performed. QuickTemp conical temporary abutments were selected to deliver immediately prefabricated cement-retained provisionals. Two months after an impression was taken with an intraoral digital scanner (3Shape Trios3, Copenhagen, Denmark). The provisional restoration optical scanning was used to transfer the functionalized prosthetic contour to be duplicated into the definitive porcelain fused to zirconia restoration cemented on customized titanium abutments.
RESULTS: A satisfying esthetic and functional result has been achieved. No biological and mechanical complications were recorded.
CONCLUSIONS: The investigated fully digital implant-prosthetic protocol provided a smooth, complication free and time effective treatment alternative to the conventional workflow. Besides the fully digital workflow allowed the surgical and prosthetic decision making and the communication within the dental team and with the patient. Further improvements heading to a direct match between the intraoral scan and the CBCT are strongly advised in order to create the so-called virtual patient.