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Journal of Peking University (Health Sciences) ›› 2020, Vol. 52 ›› Issue (5): 964-970. doi: 10.19723/j.issn.1671-167X.2020.05.029

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Digital workflow coupling conic retention for the immediate restoration of adjacent posterior implants

Jia LUO1,Yu ZHANG1,∆(),Hong-yan CUI1,Ning ZHU1,Hui-dan SHEN2,Ping DI1,Ye LIN1   

  1. 1. Department of Implantology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
    2. First Clinical Division, Peking University School and Hospital of Stomatology, Beijing 100081, China
  • Received:2018-10-10 Online:2020-10-18 Published:2020-10-15
  • Contact: Yu ZHANG E-mail:zhang76yu@163.com
  • Supported by:
    Program for New Clinical Techniques and Therapies of Peking University School and Hospital of Stomatology(PKUSSNCT-17A05)

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Abstract:

Objective: To evaluate the digital workflow coupling conic retention for the immediate restoration of adjacent posterior implants. Methods: The patients with adjacent teeth missing in the posterior jaw seeking for implant restoration in the Department of Implantology, Peking University School and Hospital of Stomatology from March, 2017 to February, 2018 were recruited. After implant placement and commercial conic retention coping delivery, the patient had an intraoral scan for digital impression, and the computer-assisted design/computer-assisted manufacturing (CAD/CAM) technology was used for the fabrication of the immediate splinted prosthesis, which was made of polymethyl methacrylate (PMMA) and loaded immediately after delivery. Six months later, all the temporary prostheses were replaced by the permanent ones made of monolithic zirconia with CAD/CAM technology as well. The parallel periapical films were taken for the temporary and permanent prostheses post-delivery. The clinical effect of this workflow was evaluated by indices including the survival rates of implants and prostheses, the change of marginal bone level, and the implant-related and prosthesis-related complications; before the final restoration, the Visual Analogue Score (VAS) was used to evaluate the satisfaction of the patients. Results: Ten patients (4 males and 6 females, 55.5 years old for average) were recruited. Totally 34 implants were placed; 14 prostheses were fabricated, temporary and permanent, respectively. After an observation period from 4 to 14 months, the survival rate for implants and prostheses were both 100%; the marginal bone level of the implants were (1.06±0.97) mm and (0.96±0.82) mm, immediate post-operation and 6 months later, respectively. The difference was not statistically significant (P>0.05). Neither implant- nor prostheses- related complications were observed. And the VAS of the patients' satisfaction was 87.2. Conclusion: For the adjacent posterior implants, the immediate prostheses manufactured by digital workflow, coupling conic retention, were clinically feasible and patient-satisfactory.

Key words: Computer-assisted design/computer-assisted manufacturing, Intraoral scan, Conic retention, Immediate loading

CLC Number: 

  • R783.4

Figure 1

Operation procedure A, implant placement; B, abutment delivery and adjustment for insertion path of the splinted prosthesis. "

Figure 2

Immediate loading procedure A-E, computer-assisted design of the temporary splinted prosthesis; F, delivery of the PMMA prosthesis. "

Figure 3

Permanent monolithic zirconia prosthesis A, buccal view of the monolithic prosthesis; B, occlusal view of the monolithic prosthesis. "

Figure 4

Measurement of marginal bone level in the parallel periapical films A, parallel periapical film of the immediate loading temporary prosthesis, the PMMA was radiotransparent; B, parallel periapical film of the permanent prosthesis, the monolithic zirconia was radiopaque. "

Table 1

General conditions of the patients, implants and prostheses"

Patient No. Gender Age/years FDI site No. Implants Prostheses
1 Female 55 45 A11 1
46 A11
2 Male 62 36 A11 1
37 A9.5
3 Female 55 34 A11 2
35 A11
36 A11
37 A9.5
45 A11
46 A11
47 A9.5
4 Female 49 35 A11 1
36 A11
37 A11
5 Female 64 35 A11 1
36 A11
37 A9.5
6 Male 39 45 A11 1
46 A11
7 Male 62 36 A11 2
37 A9.5
46 A11
47 A9.5
8 Male 49 46 A11 1
47 A9.5
9 Female 67 14 A9.5 2
15 A9.5
24 A9.5
25 A9.5
10 Female 53 15 A9.5 2
16 A11
24 A11
25 A9.5
Total 34 14

Table 2

Results of the VAS for patients’ satisfaction"

Patient No. General Comfort Esthetic Cleaning Necessity Average
1 90.0 85.0 85.0 82.0 80.0 84.4
2 90.0 80.0 85.0 75.0 95.0 85.0
3 90.0 90.0 85.0 85.0 90.0 88.0
4 100.0 90.0 85.0 85.0 80.0 88.0
5 90.0 90.0 90.0 88.0 90.0 89.6
6 90.0 90.0 88.0 85.0 90.0 88.6
7 95.0 90.0 90.0 90.0 85.0 90.0
8 85.0 85.0 90.0 85.0 90.0 87.0
9 90.0 85.0 87.0 80.0 90.0 86.4
10 85.0 86.0 80.0 80.0 90.0 84.2
Average 90.5 87.1 86.5 83.5 88.0 87.1
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