The use of computer in implant dentistry: from treatment planning to prosthetics.

The purpose of this study is to give a current overview about computer-aided planning/surgery and CAD/CAM prosthetic procedures. Explicative cases treated with these techniques are presented. The first case regards a patient (male, 55 years old), totally edentolous at the upper arch, who was scheduled for a fixed implant-supported rehabilitation. The insertion of 5 implants was planned using a dedicated software (FacilitateTM) on the basis of a CT exam and a radiopaque scan prosthesis. Flapless surgery was guided by a CAD-CAM customized surgical template. A complete resin-made temporary denture was immediately connected to the implants. The second case regards a patient (female, 35 years old), affected by single edentulism in site 1.2. A GBR procedure was made 8 months before implant placement. Implant insertion was performed by a manufactured template obtained through a computer-aided planning. Provisional restoration was connected to the implant 3 months later and suitably modified to condition periimplant soft tissues. Finally, the case was finalized by means of a customized CAD-CAM zirconia abutment (Atlantis Virtual Abutment DesignTM) and a zirconia-ceramic definitive crown. Systems of computer-aided surgical planning offer a concrete help in the definition and execution of the treatment plan, allowing a highly precise implant positioning and reducing risks of operative complications. In this way, they also facilitate the employment of innovative techniques, such as flapless surgery and immediate implant loading. The use of CAD/CAM customized implant abutments minimizes chair- and lab- operative time and increases the choice of manufacture materials compared to conventional customized abutments. Computer-aided surgical and prosthodontic procedures represent a promising innovation in implant dentistry, and have the potential for a widespread diffusion in alternative to conventional techniques.