Abutment-Level Digital Impression Using Abutment Matching Algorithm, And Insurance-Covered Implant Prosthesis By Metal 3D Printing: A Case Report

Abstract

In the process of manufacturing implant-fixed prostheses, it has traditionally required complicated procedures such as impression taking, master cast fabrication, wax-up and so on, but recently, digital impression with an intraoral scanner and workflow using computer-aided design/computer-aided manufacturing (CAD/CAM) make it possible to simplify the series of procedures mentioned above. This case report presents the implant-fixed prosthesis on posterior area using digital technology. The implant was placed in the planned position using a computer-guided implant surgical template on the first and second molars of lower right, and after 5 days of implantation, the customized abutments and provisional prostheses were delivered. The occlusal changes were evaluated through regular check-up, and the definitive prosthesis was fabricated using an intraoral scanner. A 3D images of provisional prostheses were acquired through a pre-op scan, and an automatic abutment matching algorithm on the intraoral scanner software was used to acquire the scan data. The definitive impression on the second premolar area of upper left which was covered by implant insurance was obtained with intraoral scanner using scanbody. For insurance coverage, the prosthesis was made of porcelain-fused-to-metal crown, and the metal coping was designed by CAD program and then fabricated by metal 3D printing. The porcelain on the buccal side was built by the traditional procedure. By abutment-level impression with automatic abutment matching function, it was possible to precisely obtain the subgingival margin without the need for gingival retraction cord. Moreover, the metal coping made by metal 3D printing was clinically acceptable.