Page 20 - DT Vol 15 No 3

20 I prosthodontics DENTAL TECHNOLOGY, JULY-SEPTEMBER 2025

DIGITAL FAST-TRACK IMPLANT-SUPPORTED PROSTHETIC

REHABILITATION: A CASE FROM TOOTHWORKS DENTAL LAB

PANKAJ GUPTA, DHANASHREE MINASE

INTRODUCTION
This article highlights the successful oral rehabilitation of a
Sanskrit teacher who was experiencing impaired mastication
and poor phonetics due to multiple missing teeth. A complete
prosthodontic workflow utilizing digital techniques was carried
out at Toothworks Dental Lab in Nagpur, Maharashtra.. The
process minimized the number of patient visits by combining
scanning and jaw relation in a single appointment, followed by a
PMMA trial to confirm phonetics. Subsequent steps, including
the metal and bisque trials and final prosthesis delivery,
were completed within the dental laboratory itself, ensuring
efficiency, precision, and patient comfort.

CASE BACKGROUND
A 63-year-old male Sanskrit teacher reported difficulty in Fig 1: Intraoral scanned data by using scan bodies
chewing and deteriorating clarity of speech due to progressive
tooth loss. Given the linguistic precision required in his
profession, especially in Sanskrit, where phonetic accuracy
is critical, the case demanded a solution that restored both
functional and phonetic capabilities quickly and reliably.
The patient also expressed concerns about multiple
appointments due to his tight teaching schedule and discomfort
with lengthy dental procedures. A conventional denture
fabrication approach was therefore ruled out in favour of a
streamlined digital workflow.
DIGITAL WORKFLOW OVERVIEW
1. One-Step Scanning and Jaw Relation
The process began with a digital intraoral scan (Shining 3D
Dental Aoralscan 3), capturing detailed 3D images of the
patient’s edentulous arches (Figure 1). Simultaneously, the jaw
relation was recorded using occlusal rims in the same session
to register the vertical dimension (to set the vertical stop at the
desired location after verifying esthetics and phonetics) and Fig 2a: Scanning the jaw separation with the help of occlusal rims
centric relation (Figure 2). This one-step approach eliminated
the need for multiple visits for impressions and bite registration,
reducing both clinical time and patient fatigue.

2. PMMA Trial for Phonetics and Esthetics
A trial denture was fabricated using PMMA (polymethyl
methacrylate) to evaluate the following (Figures 3a and 3b):
• Phonetics: Special attention was given to the pronunciation
of Sanskrit syllables to ensure the patient’s speech returned to
natural clarity.
• Esthetics: Lip support, smile line, and facial profile were
assessed.
• Occlusion: A balanced bite was confirmed before moving
forward.
The patient actively participated in the phonetic verification
stage, pronouncing selected Sanskrit verses to validate speech
clarity.

CAD Design with exocad Software Fig 2b: Scanned file models
The scanned data was imported into exocad, a powerful and
versatile CAD platform developed specifically for dental harmony with facial anatomy
applications. Using exocad, the digital dental technician at The exocad environment enabled real-time adjustments, enhanced visualization,
Toothworks Dental Lab performed the following: and precise modeling before any physical material was fabricated—an essential step in
• Designed a virtual wax-up of the complete denture reducing errors and remakes (Figure 4).
• Verified and adjusted the occlusal scheme
• Simulated and evaluated speech-related dynamics, particularly 3. In-Lab Metal Trial
tooth positioning relevant to phonetic sounds To streamline treatment, the metal framework trial was conducted entirely within
• Customized the smile line, tooth axis, and gingival contours in Toothworks Dental Lab (Figure 5). This not only reduced the number of clinic visits but