Why a new digital protocol is needed
Removable dental prostheses represent a fundamental solution for the rehabilitation of edentulous patients, but traditional workflows have significant limitations: numerous clinical stages, intensive use of materials, operator-dependent variability, and long times.
The conventional workflow is based on physical impressions, plaster models, and multiple intermediate steps, with a significant impact in terms of time, costs, and standardization of results.
The limitation of current digital systems
CAD-CAM technologies have introduced important innovations, but in most cases, digitalization only pertains to the laboratory. The clinical phase remains analog and requires the conversion of impressions and models into digital data.
This hybrid approach reduces efficiency and keeps the complexity of the process high.
The key step: intraoral scanning
A truly digital workflow begins when the impression is natively digital.
Intraoral scanning allows for the direct acquisition of the morphology of the arches in the form of files, eliminating impression materials and physical models, and enabling immediate integration into the digital flow.
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The critical issues to overcome
The use of intraoral scanning in edentulous patients is limited by some critical issues:
- instability of the mucosal tissues
- difficulty in complete acquisition
- absence of protocols for interarch relationships
- difficulty in transferring aesthetic and functional parameters
Without a solution to these aspects, a fully digital workflow is not achievable.
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Objective of the protocol
The protocol aims to enable a fully digital workflow through:
- predictable intraoral scans even in total edentulism
- correct registration of interarch relationships
- transfer of aesthetic parameters
- integration with CAD-CAM technologies
- elimination of impressions and physical models
Workflow structure
The process is divided into two main phases.
The clinical phase includes the acquisition of anatomical and functional data through intraoral scanning and dedicated recordings.
The digital phase includes processing, CAD design, and CAM production of the prosthesis.
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Phases of the protocol
The first phase consists of intraoral scanning of the edentulous arches. This is performed with dedicated strategies and auxiliary tools that allow to stabilize the tissues, improve visibility and guide the movement of the scanner, increasing accuracy.
The scans are then processed and converted into three-dimensional models usable in the digital workflow.
Subsequently, wax valleys are designed and created based on digital data, used to record interarch relationships and fundamental aesthetic parameters.
Interarch relationships are clinically recorded and transferred into the digital flow, along with information such as vertical dimension, occlusal plane, and support of the soft tissues.
Facial scanning allows for the integration of intraoral data with the facial context, creating a digital patient useful for design.
The scans are then aligned to achieve a correct spatial relationship between the arches.
At this point, the CAD design of the prosthesis is carried out using all the collected information.
Production occurs through CAM technologies, such as milling or 3D printing.
Finally, the prosthesis is verified, finalized, and delivered to the patient.
Advantages of the digital workflow
For the patient, this approach reduces the number of appointments, improves comfort, and eliminates invasive procedures such as traditional impressions.
For the dental practice, it allows for greater efficiency, cost reduction, and standardization of procedures.
Overall, it promotes access to care, reduces environmental impact, and improves the quality of outcomes.
Conclusion
A completely digital protocol based on intraoral scanning represents a significant evolution in removable prosthetics.
The quality of the result also depends on the tools used.
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It simplifies the process, increases predictability, and improves quality while reducing time and costs.