CASE OVERVIEW
This case is presented from the provisional stage to the definitive prosthetics of a full-arch All-on-4 implant rehabilitation.
INITIAL CHALLENGES
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The patient liked his natural teeth and wanted to preserve their shape while improving overall aesthetics.
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The patient presented with a misaligned jaw.
PLANNING & DESIGN STRATEGY
We opted to replicate the patient’s natural dentition by creating an exact copy of the canines, lateral incisors, and central incisors, then rearranging them to improve aesthetics. CBCT data and smile photographs captured in the natural head position were used to design the prosthesis in the correct occlusal planes.
The doctor planned to extract the remaining teeth while preserving the alveolar bone in order to fabricate an FP1-type prosthesis. Following this approach, we virtually extracted the teeth and designed the prosthetic teeth to be supported within the alveoli, preserving the gingival contours from the provisional stage through to the definitive restoration.
The provisionals were first designed to be milled in PMMA. Later, the definitive prosthesis was replicated from the provisional with minor adjustments, resulting in a zirconia structure supported by a titanium bar.
EXECUTION & TOOLS:
• Mixed workflow Exocad and Blender
IMAGES / SCREENSHOTS:
1. Initial situation
2. Alignment using CBCT data combined with scans and 2D photographs
3. Copy of the patient’s natural teeth
4. New tooth arrangement following aesthetic principles for fabrication of the provisionals
5. Provisional prosthesis occlusally locked in position, supported on tooth #47, to facilitate accurate placement according to the surgical planning after implant surgery
6. Definitive prosthesis designed based on the provisional and then transformed into a titanium I-bar (designed by Profile of Lanasdesigns - CadCam Masters)
7. Final result
I hope you enjoyed this case and found the workflow and design approach helpful. Our focus was on preserving the patient’s natural characteristics while enhancing aesthetics and function through thoughtful planning and execution. Thanks for taking the time to check it out—feel free to share your thoughts or experiences with similar cases!s
