1.Clinical decision-making for immediate restoration of terminal dentition: determination and transfer of jaw relations.
Yiping GU ; Shengtao YANG ; Quan YUAN
West China Journal of Stomatology 2025;43(6):763-770
Immediate implant-supported fixed restoration in edentulous jaws demonstrates a success rate comparable to that of conventional implant restoration. However, this approach still presents a certain degree of technique sensitivity. In the field of immediate implant-supported fixed restoration in dentistry, a repeatable and stable jaw relation is the prerequisite for the design and fabrication of prostheses. It also reduces chairside denture placement and occlusal adjustment time and lowers the risk of occlusion-related complications. For patients with terminal dentition, the precise transfer of jaw relation following full-arch implantation serves as the fundamental basis for implant-supported occlusal reconstruction and functional restoration. This process is also a key research focus and challenge in the area of implant-supported occlusal rehabilitation. This review summarizes the procedures and methods for determining and transferring jaw relation in immediate implant-supported fixed restoration. It aims to serve as a basis for clinical decision making in implant-supported fixed restorations for terminal dentition patients.
Humans
;
Dental Prosthesis, Implant-Supported
;
Clinical Decision-Making
;
Immediate Dental Implant Loading
;
Jaw, Edentulous/surgery*
2.Comparative study on the accuracy of extraoral scanning versus intraoral scanning in digital impressions for implant restoration in edentulous jaws.
Yongtao YANG ; Xin LI ; Xiangyi SHANG ; Shenyao SHAN ; Wenbo LI ; Qingzhao QIN ; Yong WANG ; Yijiao ZHAO
West China Journal of Stomatology 2025;43(6):771-779
OBJECTIVES:
To evaluate the accuracy of a self-developed extraoral scanning system based on four-camera stereophotogrammetric technology in the acquisition of three-dimensional positional information on dental implants and conduct a comparative study involving an intraoral scanning system.
METHODS:
With the use of an in vitro edentulous jaw model with implants, extraoral (experimental group) and intraoral (control group) scanning systems were employed to obtain STL (Standard Tessellation Language) datasets containing three-dimensional morphological and positional information on scan bodies. In addition, a dental model scanner was used to obtain reference data. The three-dimensional morphological, linear, and angular deviations between groups and reference data were analyzed using Geomagic Wrap 2021 software to compare trueness and precision.
RESULTS:
The extraoral scanning system demonstrated superior trueness in three-dimensional morphological, linear, and angular deviations compared with the intraoral scanning system, with statistically significant differences (P<0.001). The extraoral scanning system also showed a higher precision in three-dimensional morphological deviation (P<0.001). As the number of implants increased, the extraoral scanning system exhibited increased three-dimensional morphological and linear deviations (P<0.001) but maintained a stable angular deviation. The intraoral scanning system displayed significant increases in three-dimensional morphological, linear, and angular deviations with the increase in the number of implants (P<0.05).
CONCLUSIONS
The stereophotogrammetry-based extraoral scanning system outperforms intraoral scanning system in terms of the accuracy for multi-unit implant positioning and provides a novel approach for attaining a fully digital workflow for implant rehabilitation in edentulous jaws.
Jaw, Edentulous
;
Humans
;
Dental Impression Technique
;
Dental Implants
;
Imaging, Three-Dimensional/methods*
;
Photogrammetry/methods*
;
Models, Dental
3.A clinical application study of digital manufacturing simple intraoral Gothic arch-tracing device in determining the centric relation of complete dentures.
Tuan Feng ZHOU ; Xue YANG ; Rui Jie WANG ; Ming Xuan CHENG ; Hua ZHANG ; Jin Qi WEI
Journal of Peking University(Health Sciences) 2023;55(1):101-107
OBJECTIVE:
To verify the consistency between the digital manufacturing simple intraoral Gothic arch-tracing device and the traditional intraoral Gothic arch-tracing device in determining the centric relation of complete dentures restoration.
METHODS:
Ten outpatients with edentulous jaws were selec-ted, and the centric relation of the patients was determined by digital manufacturing of simple intraoral Gothic arch-tracing device (T1) and traditional intraoral Gothic arch-tracing device (T2); the difference of clinical operation time between the two methods was recorded; the upper and lower edentulous jaw plaster models were scanned with two kinds of centric relation, the Standard Triangle Language (STL) files imported into Geomagic studio software to apply the best fitting of multiple points of the both upper jaw models, the fitted STL files imported into the 3 shape viewer software, and the maximum position deviations of the vertical, labial (buccal) and lingual directions of the mandibular midline area and molar areas in T1 and T2 groups measured. During the clinical complete dentures try-in, we observed whether there was midline deviation in the mouth of T1 group and T2 group, and whether the occlusion of posterior teeth was stable or not.
RESULTS:
The mean time spent on determining the centric relation of T1 and T2 groups was (41.90±2.64) min, (57.50±2.37) min respectively. Paired t test was conducted in the two groups, P < 0.01 with significant statistical difference; The mean maximum position deviation between T1 group and T2 group of the midline mandibular region in labial lingual direction was (0.32±0.14) mm, that was (0.40±0.23) mm in vertical direction; the mean maximum position deviation of molar area in buccal lingual direction was (0.35±0.23) mm and that was (0.33±0.20) mm in vertical direction. In the vertical and horizontal directions, the maximum position deviation of mandibles between group T1 and group T2 was controlled within 0.5 mm. In the process of clinical complete dentures try-in, there was no deviation from the center line of dentures. There was not warping, swinging and other poor stability phenomena in T1 and T2 groups.
CONCLUSION
The digital manufacturing of simple intraoral Gothic arch-tracing device can be used to determine the centric relation of complete dentures, which can not only save time of clinical operation, but also ensure the accuracy of the centric relation.
Humans
;
Centric Relation
;
Jaw Relation Record/methods*
;
Denture, Complete
;
Mouth, Edentulous
;
Jaw, Edentulous
4.A comparative study based on the mandibular movement track and the movement parameters of the virtual articulator in simulating occlusal adjustment.
Liya MA ; Jiarui CHAO ; Fei LIU ; Jiansong MEI ; Jiefei SHEN
West China Journal of Stomatology 2023;41(3):254-259
OBJECTIVES:
This study aimed to compare the effects of virtual adjustment on occlusal interferences in mandibular posterior single crown and three-unit bridge restorations by using the mandibular movement track and the movement parameters of a virtual articulator.
METHODS:
Twenty-two participants were recruited. Digital casts of the maxillary and mandibular arches were obtained using an intraoral scanner, and the jaw registration system was used to record the data of the mandibular movement track and the movement parameters of the articulator. Four kinds of restorations with 0.3 mm occlusal interferences were designed with dental design software. In particular, single crowns were designed for teeth 44 and 46, whereas three-unit bridges were designed for teeth 44-46 and 45-47, and the corresponding natural teeth were virtually extracted. Virtual adjustment of the restorations was performed using two dynamic occlusal recordings, namely, the mandibular movement track and the movement parameters of the virtual articulator. A reverse-engineering software was used to measure the root-mean-square of the three-dimensional deviation of the occlusal surfaces between natural teeth and the adjusted restorations. The differences between the two methods of virtual-occlusion adjustment were compared and analyzed.
RESULTS:
For the same group of restorations, the three-dimensional deviation of the mandibular movement track group were lower than those of the virtual articulator group, and the differences were statistically significant (P<0.05). For the four groups of restorations adjusted by the same method, the three-dimensional deviation of the 46-tooth single crown was the largest and the smallest three-dimensional deviation was that of the 44-tooth single crown. Statistical differences existed between the 44-tooth single crown and the other groups (P<0.05).
CONCLUSIONS
For the occlusal design of posterior single crown and three-unit bridge, the mandibular movement track could be a more effective approach to virtual occlusal adjustment than the movement parameters of the virtual articulator.
Humans
;
Mouth, Edentulous
;
Occlusal Adjustment
;
Jaw Relation Record
;
Dental Articulators
;
Software
5.Application evaluation of prefabricated rigid connecting bar in implants immediate impression preparation of edentulous jaw.
Juan WANG ; Hua Jie YU ; Jing De SUN ; Li Xin QIU
Journal of Peking University(Health Sciences) 2022;54(1):187-192
OBJECTIVE:
To compare the operation complexity and accuracy of traditional splint impression technique and impression technique with prefabricated rigid connecting bar system for full-arch implants-supported fixed protheses in vitro.
METHODS:
Standard mandibular edentulous model with six implant analogs was prepared. The implants were placed at the bone level and multiunit abutments screwed into the implants. Two impression techniques were performed: the traditional splint impression technique was used in the control group, and the rigid connecting bar system was used in the test group. In the control group, impression copings were screwed into the multiunit abutments and connected with autopolymerizing acrylic resin. Open tray impression was fabricated with custom tray and polyether. In the test group, cylinders were screwed into the multiunit abutments. Prefabricated rigid bars with suitable length were selected and connected to the cylinders with small amount of autopolymerizing acrylic resin, and open tray impression was obtained. Impression procedures were repeated 6 times in each group. The working time of the two impression methods were recorded and compared. Analogs were screws into the impressions and gypsum casts were poured. The gypsum casts and the standard model were transferred to stereolithography (STL) files with model scanner. Comparative analysis of the STL files of the gypsum casts and the standard model was carried out and the root mean square (RMS) error value of the gypsum casts of the control and test groups compared with the standard model was recorded. The trueness of the two impression techniques was compared.
RESULTS:
The work time in the test group was significantly lower than that in the control group and the difference was statistically significant [(984.5±63.3) s vs. (1 478.3±156.2) s, P < 0.05]. Compared with the standard model, the RMS error value of the implant abutments in the test group was (16.9±5.5) μm. The RMS value in the control group was (20.2±8.0) μm. The difference between the two groups was not significant (P>0.05).
CONCLUSION
The prefabricated rigid connecting bar can save the chair-side work time in implants immediate loading of edentulous jaw and simplify the impression process. The impression accuracy is not significantly different from the traditional impression technology. The impression technique with prefabricated rigid connecting bar system is worthy of clinical application.
Acrylic Resins
;
Calcium Sulfate
;
Dental Implants
;
Dental Impression Materials
;
Dental Impression Technique
;
Humans
;
Jaw, Edentulous
;
Models, Dental
;
Mouth, Edentulous
6.Accuracy and retention of denture bases fabricated by injection molding, milling, and three-dimensional printing.
Dan LI ; Sheng Tao YANG ; Quan YUAN ; An Chun MO ; Li YUE
Chinese Journal of Stomatology 2022;57(9):927-931
Objective: To compare the accuracy and retention of denture bases fabricated by injection molding, milling, and three-dimensional (3D) printing fabricating, in order to provide some references for clinical practice. Methods: A maxillary edentulous jaw model made was used to duplicated 10 working casts. The casts were numbered and scanned. The wax pattern was designed by digital ways and conventional methods and then the denture bases were fabricated by injection molding, milling, and 3D printing. The tissue surface of experimental denture base was obtained using a dental laboratory scanner. The deviation between the tissue surface of the fabricated denture bases and the working model was evaluated. A digital force gauge was used to measure the traction force. Results: The milling group [(0.076±0.026) mm] was more accurate than the 3D printing group [(0.117±0.041) mm] (P<0.05) and the injection group [(0.120± 0.025) mm] (P<0.05). The accuracy of 3D printing group and that of injection group were not statistically significant (P>0.05). The milling group [(9.55±2.44) N] demonstrated greater retentive force than 3D printing group [(5.19±0.06) N] and injection molding group [(1.52±0.52) N] (P<0.05). Conclusions: The denture base fabricated by milling was more accurate and showed the greatest retentive force than the other groups. And 3D printing group showed better retentive force than the injection molding group. Both digital manufacturing methods can meet the requirements of clinical application.
Computer-Aided Design
;
Denture Bases
;
Humans
;
Jaw, Edentulous
;
Maxilla
;
Printing, Three-Dimensional
7.Research advances in the use of dynamic navigation technology for implantation in the edentulous jaw.
Xin Yue ZHANG ; Bo Xiang WANG ; Li Xuan XIAO ; Hui Ming WANG
Chinese Journal of Stomatology 2022;57(10):1079-1083
The use of dynamic navigation technology in edentulous jaw implant restoration can solve many problems associated with traditional edentulous jaw implant restoration. The benefits of dynamic navigation include fine positioning guidance, restoration-guided surgery, good aesthetic results, and the possibility of simultaneous conceptual design and real-time implant guidance, as well as the transition from "blind" to "direct" vision during the implantation. It can guide clinicians and adjust the plan in real time, improve the efficiency of communication between the clinician, technician, and patient throughout the process and so on. The workflow, current clinical application and challenges, accuracy analysis, and limitations of the dynamic navigation technology in the edentulous jaw are discussed in this paper, as well as an outlook on its future development, with the goal of contributing to the clinical development of dynamic navigation-guided implantology in the edentulous jaw.
Humans
;
Dental Implantation, Endosseous/methods*
;
Dental Implants
;
Surgery, Computer-Assisted/methods*
;
Esthetics, Dental
;
Jaw, Edentulous/surgery*
;
Technology
8.Risk analysis and preventive strategies of implant placement in patients with hypertension.
Yu Zi XU ; Si Yuan WANG ; Chuan ZHOU ; Fu Ming HE
Chinese Journal of Stomatology 2022;57(4):430-435
Recently, among the edentulous patients who undergo dental implants, the proportion of hypertensive patients remains high, which poses a greater challenge for clinicians to operate and to maintain the therapeutic effect. The present review comprehensively summarized clinical researches about the adverse effects on dental implants, outlined molecular mechanisms of the positive effects of various antihypertensive drugs on bone metabolism, and proposed that clinicians should select preventive strategies during preoperative and intraoperative procedures according to the blood pressure of patients with hypertension.
Alveolar Bone Loss
;
Dental Implantation, Endosseous/methods*
;
Dental Implants
;
Dental Prosthesis, Implant-Supported
;
Dental Restoration Failure
;
Humans
;
Hypertension/surgery*
;
Jaw, Edentulous
;
Maxilla/surgery*
;
Risk Assessment
9.Interarch distance is a target restorative space value: clinical decisionmaking of implant restoration guided by measured value.
West China Journal of Stomatology 2021;39(2):233-237
When design an implant restoration for edentulous patients, many doctors ignore the sufficiency of the interarch distance (vertical distance) or horizontal distance of the patient to accommodate the superstructure and restoration before designing the implant plan. However, the connotation of measuring the interarch distance or horizontal distance has not been clarified in clinical practice. It is often based on visual estimation after operation, and the decision-making path of implant restoration is inverted, resulting in many mistakes regarding the restoration after implantation. The main reason is the lack of standardized paths and practical methods to use before surgery. This article recommended initially establishing a maxillo-mandibular relationship based on natural teeth, old dentures, or new ones and then using the height and horizontal distance or angle of the target restorative space, which was easier to grasp as the measured index. The minimum vertical distance (including the height of the gingival surface and the bone surface) and the horizontal distance (or the angle from the bone or gingival surface to the proposed occlusal plane) should be measured before operation. A decision tree of edentulous jaw restoration guided by the values of the repair space was established based on the measured values. This article clarified the measuring points and planes and thus provided a quantitative relationship basis for the design of implant restoration.
Dental Implantation, Endosseous
;
Dental Implants
;
Dental Prosthesis, Implant-Supported
;
Humans
;
Jaw, Edentulous
;
Mandible
;
Mouth, Edentulous
10.Clinical assessment of pterygoid and anterior implants in the atrophic edentulous maxilla: a retrospective study.
Jin WU ; Kun LIU ; Ming LI ; Zhi-Jun ZHU ; Chun-Bo TANG
West China Journal of Stomatology 2021;39(3):286-292
OBJECTIVES:
This study aims to evaluate the short-term clinical outcomes and patient satisfaction of anterior and pterygoid implants in the rehabilitation of edentulous maxilla with posterior atrophy.
METHODS:
Given a minimum follow-up of 1 year, 25 patients with fixed maxillary rehabilitation over anterior and pterygoid implants were enrolled in this retrospective study. The implant survival rates, peri-implant soft tissue status (including probing depth, modified sulcus bleeding index, and plaque index), marginal bone loss, and patient satisfaction were measured.
RESULTS:
The survival rates for anterior and pterygoid implants at 1-year follow-up were 96.5% and 97.8%, respectively (
CONCLUSIONS
For the edentulous maxilla with posterior atrophy, full-arch fixed prostheses supported by anterior and pterygoid implants has an acceptable short-term clinical outcome and excellent patient satisfaction. It may be considered as a predictable and feasible method for maxillary rehabilitation.
Atrophy/pathology*
;
Dental Implantation, Endosseous
;
Dental Implants
;
Dental Prosthesis, Implant-Supported
;
Follow-Up Studies
;
Humans
;
Jaw, Edentulous/surgery*
;
Maxilla/surgery*
;
Retrospective Studies
;
Treatment Outcome

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