Page 34 - DT Vol 15 No 3

34 I implantology DENTAL TECHNOLOGY, JULY-SEPTEMBER 2025

• Immediate temporaries during the
interim period while the laboratory
process for the definitive prosthesis can be
executed.
Relief areas were incorporated to prevent
soft tissue compression, and windows
were provided for resin pickup of implant
copings.

3. Surgical phase
All remaining teeth were atraumatically
extracted, and implants were placed using
a fully guided protocol with multi-unit
abutments. Primary stability exceeding 35
Ncm was achieved for immediate loading.

Fig 5f: Bar designing video, scan QR to Fig 5g: Intraoral bar trial
have a quick glimpse

Resin Trial

Fig 6a: 3D printed resin prototype Fig 6b: Intraoral verification using the prototype Fig 6c: Short video of the intraoral
Resin Trial

Fig 7a: Designing of the final superstructure Fig 7b: Characterisation using Miyo staining Fig 7c: Miyo liquid staining technology

4. Immediate pickup and occlusion verification 6. PMMA prototype trial
The 3D printed shell templates were seated intraorally, and the implant A PMMA prototype over the bar was tried and verified clinically, to evaluate
abutment non-engaging copings were picked up using resin, while esthetics, phonetics, and occlusion, allowing fine adjustments before final
preserving the pre-planned VDO and occlusion. The device was removed in fabrication.
situ, to create a verified master cast, accurately replicating implant positions
and occlusion. 7. Final zirconia prosthesis
3D printed resin crowns were picked using a dual cure resin and loaded as A monolithic multilayer zirconia prosthesis was fabricated and bonded to
immediate provisionals during the interim period. the titanium bar, ensuring strength and aesthetics. Occlusal refinements
included establishing even centric contacts with group function.
5. iBar design and fabrication 8. Delivery on day 5
The verified cast was scanned for bar design, followed by CAD-CAM The final prosthesis was torqued on day five post-surgery, and screw channels
fabrication of a titanium bar at multi-unit abutment level, ensuring passive were sealed. Occlusion and esthetics were verified, and hygiene instructions
fit. The Sheffield test confirmed passivity intraorally. were provided.
The titanium bar was designed digitally to ensure optimal support for the
final restoration while maintaining a low profile for hygiene and soft tissue RESULTS
health. It was CAD-CAM milled to achieve a passive fit verified intraorally The patient achieved immediate functional and esthetic rehabilitation within
with the Sheffield test. For the final restoration, a monolithic multilayer a week’s time with:
zirconia was milled (Dental Direkt Cubeone ML), providing high strength • Restored facial profile and esthetics.
and natural esthetics. It was bonded to the titanium bar to combine structural • Preserved VDO and occlusal relationships.
stability with the esthetic benefits of zirconia, ensuring functional occlusion • Elimination of the edentulous phase.
and long-term durability • Immediate masticatory and phonetic function.
• Passive fit and long-term maintainability of the prosthesis.