Tim Joda

Aim This scoping review aimed to compile and evaluate clinical trials investigating digital applications in prosthetic diagnostics and treatment planning by assessing their clinical relevance and future potential. Methods Following the PCC‐framework for scoping reviews and combining the source of analysis (Population/P: “prosthodontics”), the technique of interest (Concept/C: “digital application”) and the field of interest (Context/C: “diagnostics”), a three‐pronged search strategy was applied in the database PubMed and Web of Science. Clinical trials (≥10 study participants, English/German) were considered until 2023‐03‐09. Reporting adhered to the PRISMA‐ScR statement. Results The search identified 520 titles, of which 18 full‐texts met the inclusion criteria for data extraction. The trials involved a total of 14,457 study participants and were mapped for prosthetic subdisciplines: fixed ( n = 9; 50%) and removable ( n = 4; 22%) prosthodontics, reconstructive dentistry in general ( n = 3; 17%), and temporo‐mandibular joint disorders ( n = 2; 11%). Data merging of medical format files, as DICOM+STL, was the dominant digital application ( n = 7; 39%); and virtual treatment simulation using digital smile design or digital wax‐up represented the most frequent prosthetic diagnostics ( n = 6; 33%). Conclusion This scoping review identified a relatively low number of clinical trials. The future potential of digital diagnostics appears to be mostly related to the subdiscipline of fixed prosthodontics, especially regarding virtual treatment simulation for communication with the patient and among dental professionals. Artificial intelligence emerged as a key technology in many of the identified studies. Further research in this area is needed to explore the capabilities of digital technologies in prosthetic diagnostics and treatment planning.

Objective Complete arch implant rehabilitation necessitates meticulous treatment planning and high‐level collaboration between surgical and prosthetic dental teams. Emerging virtual technologies hold considerable promise in streamlining this process. The aim of this article is to extend recommendations to clinicians venturing into the virtual patient‐assisted esthetic implant rehabilitation workflow. Overview This article summarizes recommendations for virtual patient‐assisted esthetic implant rehabilitation in the following five aspects: three‐dimensional data handling and superimposition, occlusion and virtual articulator integration in creating virtual patients, streamlined face‐ and prosthetic‐driven surgical planning, reuse of presurgical data (“Copy & Paste”), and final impression for passive fitting of final restoration. To illustrate these principles, a case with complete‐mouth implant rehabilitation completed within six visits using this virtual patient workflow is presented. Conclusion The virtual patient workflow serves as an invaluable tool to perform treatment planning, enhance efficiency, and ensure predictable outcomes in esthetic complete arch implant rehabilitation. Clinical Significance Virtual workflows are increasingly prevalent in esthetic implant rehabilitation. Nevertheless, these workflows necessitate a distinct set of knowledge and tools divergent from conventional dentistry practices. This article offers guidelines and recommendations for dental clinicians who are new to this field.

Patients with Kennedy Class I are usually treated with clasp-retained removable partial dentures (RPDs) as the prosthetic gold standard. For additional stabilization of the RPD, clinicians are often confronted with the question of secondary implant placement, which requires the fabrication of new prostheses. This case report is part of an ongoing multi-center randomized controlled study (RCT) investigating conventional RPDs without and with supplementary implants. A design of the RPD framework, including matrix housings, is crucial to enable subsequent implant retention or support. Ultra-short implants (Straumann TL 4.1 × 4 mm) offer the opportunity for additional support and retention in the edentulous posterior region, where bone availability is often reduced. This future-oriented and minimally invasive approach with virtual treatment planning and guided implant surgery offers the possibility of simplified functional and cost-effective aftercare.

Objectives Group‐2 reviewed the scientific evidence in the field of «Technology». Focused research questions were: (1) additive versus subtractive manufacturing of implant restorations; (2) survival, complications, and esthetics comparing prefabricated versus customized abutments; and (3) survival of posterior implant‐supported multi‐unit fixed dental prostheses. Materials and Methods Literature was systematically screened, and 67 publications could be critically reviewed following PRISMA guidelines, resulting in three systematic reviews. Consensus statements were presented to the plenary where after modification, those were accepted. Results Additively fabricated implant restorations of zirconia and polymers were investigated for marginal/internal adaptation and mechanical properties without clear results in favor of one technology or material. Titanium base abutments for screw‐retained implant single crowns compared to customized abutments did not show significant differences concerning 1‐year survival. PFM, veneered and monolithic zirconia implant‐supported multi‐unit posterior fixed dental prostheses demonstrated similar high 3‐year survival rates, whereas veneered restorations exhibited the highest annual ceramic fracture and chipping rates. Conclusions For interim tooth‐colored implant single crowns both additive and subtractive manufacturing are viable techniques. The clinical performance of additively produced restorations remains to be investigated. Implant single crowns on titanium base abutments show similar clinical performance compared to other type of abutments; however, long‐term clinical data from RCTs are needed. The abutment selection should be considered already during the planning phase. Digital planning facilitates 3D visualization of the prosthetic design including abutment selection. In the posterior area, monolithic zirconia is recommended as the material of choice for multi‐unit implant restorations to reduce technical complications.