This case report describes the use of CAD-based digital tooth arrangement to overcome the limitations of conventional methods in a patient with a maxillary arch wider than the average Korean morphology. In such wide arches, average-based tooth arrangement often restricts the ability to adjust the occlusal plane and cusp positions, thereby limiting functional and esthetic reproduction.In this case, virtual tooth arrangement and occlusal analysis were performed using CAD software, and a putty index was fabricated on a 3D-printed reference model to guide the final arrangement. The fabricated maxillary cast metal complete denture and mandibular distal extension removable partial denture successfully achieved bilateral balanced occlusion, and the patient reported high satisfaction in both functional and esthetic aspects. This case highlights the clinical utility of digital tooth arrangement in atypically wide arches and suggests that CAD-assisted workflows can enhance accuracy and reproducibility in clinical prosthodontics.

With the advancement of digital technology, the clinical application of CAD-CAM systems in dentistry has been expanding. CAD-CAM technology is now being utilized not only for fixed dental prostheses but also in the fabrication of removable dentures. However, its use in removable partial dentures has primarily focused on fabricating metal frameworks, with insufficient research on intraoral fitness and long-term prognosis. Recently, CAD-CAM technology has enabled the fabrication of customized artificial teeth, offering several advantages such as the establishment of precise occlusal relationships, reduced laboratory time, and ease of reproduction. This case reports on a patient who presented with discomfort due to mobility of the mandibular anterior teeth and multiple missing posterior teeth. Given the patient’s economic and systemic conditions, fabrication of a mandibular removable partial denture was chosen as the treatment option.Clinical examination revealed occlusal wear and supraeruption in the maxillary dentition, resulting in an uneven occlusal plane. To achieve a more precise occlusal relationship and accurate tooth arrangement, customized artificial teeth were fabricated using CAD-CAM technology. Despite the uneven and non-ideal occlusal plane, a removable partial denture incorporating these CAD-CAM customized artificial teeth was successfully delivered, resulting in satisfactory functional and esthetic outcomes.

The integration of cone beam computed tomography (CBCT) and intraoral scanner (IOS) data through superimposition enables comprehensive evaluation of hard and soft tissue anatomy. While this technique has demonstrated clinical efficacy for implant and orthognathic surgery planning, its implementation in prosthetic treatment design and diagnosis remains limited. Through precise registration of CBCT and IOS data sets, clinicians can quantitatively assess alveolar bone dimensions, interproximal bone levels, and soft tissue biotype. This information enables establishment of patient-specific design criteria for prosthetic contours and interproximal contact areas. Additionally, this integrated approach facilitates evaluation of midline discrepancies, jaw asymmetries, and available restorative space for long-span fixed dental prostheses. Furthermore, the immediate gingival displacement that occurs following removal of the provisional prostheses necessitates standardized protocols for precise transfer of the subgingival emergence profile established by provisional prostheses to definitive prostheses. This clinical report describes CBCT-IOS superimposition-based digital analysis for anterior esthetic restorations, with successful transfer of subgingival emergence profile from the provisional to the definitive prostheses.

This case report describes a customized PEEK healing abutment fabricated using CAD-CAM technology to ensure the aesthetics of an anterior implant prosthesis.A 3-dimensional surgical guide was designed and printed to plan the ideal placement of implant, and the healing abutment was designed by CAD software to ensure the appropriate peri-gingival tissue at that location. The CAD-CAM Ti-base PEEK abutment was tightened right after the installation of implant fixture. After approximately 2 ‒ 3 months of observation, soft tissue healing and implant fixture stability were confirmed. The intraoral scanning before removing a healing abutment, after removing it which is for sub-gingival tissue, and with scan body were performed separately for the final prosthesis and all scan files were superimposed to design and fabricate the final prosthesis to ensure both aesthetic and functional performance. The final prosthesis fit comfortably without compressing the surrounding soft tissue, and the patient was functionally and esthetically satisfied with the outcome.

To enhance the predictability of aesthetic treatment outcomes in aesthetic prosthetic restorations, considerations must include analysis of facial features, the relationship between teeth and lips, proportions of tooth width/length, gingival form, and more.Traditional diagnostic wax-ups have limitations in considering the patient’s facial features and are unable to facilitate rapid formmodifications. With recent advancements in digital technology, it is now possible to digitize the patient’s facial features in three dimensions, enabling the design of restorations that harmonize with facial features. These digital workflows not only improve efficiency but also provide patients with faster visualization of treatment outcomes, thereby enhancing motivation. Therefore, in this case, a treatment plan is devised to utilize digital diagnostic wax-ups considering the patient’s facial features for the finalprosthetic design.

In the case of skeletal class III edentulous patients, the stability of dentures can be achieved by using a crossbite by considering the residual ridge relationship when fabricating complete dentures. Forming the anterior teeth in a normal occlusal relationship in a skeletal class III ridge relationship may reduce the stability of the denture by increasing the anterior cantilever. However, when patients use complete dentures, not only functional aspects but also aesthetic aspects are important. The aesthetics of complete dentures depends on how the anterior artificial teeth are arranged, and cases of complete denture fabrication using normal occlusion or edge-to-edge bite in edentulous patients with skeletal class III ridge relationships have been reported. In this case, complete dentures were fabricated for an edentulous patient with a skeletal class III edentulous patients by forming anterior edgeto-edge bite considering neutral zone in maxillary anterior teeth, and good aesthetic and functional results were obtained.

To enhance the predictability of aesthetic treatment outcomes in aesthetic prosthetic restorations, considerations must include analysis of facial features, the relationship between teeth and lips, proportions of tooth width/length, gingival form, and more.Traditional diagnostic wax-ups have limitations in considering the patient’s facial features and are unable to facilitate rapid formmodifications. With recent advancements in digital technology, it is now possible to digitize the patient’s facial features in three dimensions, enabling the design of restorations that harmonize with facial features. These digital workflows not only improve efficiency but also provide patients with faster visualization of treatment outcomes, thereby enhancing motivation. Therefore, in this case, a treatment plan is devised to utilize digital diagnostic wax-ups considering the patient’s facial features for the finalprosthetic design.

In the case of skeletal class III edentulous patients, the stability of dentures can be achieved by using a crossbite by considering the residual ridge relationship when fabricating complete dentures. Forming the anterior teeth in a normal occlusal relationship in a skeletal class III ridge relationship may reduce the stability of the denture by increasing the anterior cantilever. However, when patients use complete dentures, not only functional aspects but also aesthetic aspects are important. The aesthetics of complete dentures depends on how the anterior artificial teeth are arranged, and cases of complete denture fabrication using normal occlusion or edge-to-edge bite in edentulous patients with skeletal class III ridge relationships have been reported. In this case, complete dentures were fabricated for an edentulous patient with a skeletal class III edentulous patients by forming anterior edgeto-edge bite considering neutral zone in maxillary anterior teeth, and good aesthetic and functional results were obtained.

To enhance the predictability of aesthetic treatment outcomes in aesthetic prosthetic restorations, considerations must include analysis of facial features, the relationship between teeth and lips, proportions of tooth width/length, gingival form, and more.Traditional diagnostic wax-ups have limitations in considering the patient’s facial features and are unable to facilitate rapid formmodifications. With recent advancements in digital technology, it is now possible to digitize the patient’s facial features in three dimensions, enabling the design of restorations that harmonize with facial features. These digital workflows not only improve efficiency but also provide patients with faster visualization of treatment outcomes, thereby enhancing motivation. Therefore, in this case, a treatment plan is devised to utilize digital diagnostic wax-ups considering the patient’s facial features for the finalprosthetic design.

In the case of skeletal class III edentulous patients, the stability of dentures can be achieved by using a crossbite by considering the residual ridge relationship when fabricating complete dentures. Forming the anterior teeth in a normal occlusal relationship in a skeletal class III ridge relationship may reduce the stability of the denture by increasing the anterior cantilever. However, when patients use complete dentures, not only functional aspects but also aesthetic aspects are important. The aesthetics of complete dentures depends on how the anterior artificial teeth are arranged, and cases of complete denture fabrication using normal occlusion or edge-to-edge bite in edentulous patients with skeletal class III ridge relationships have been reported. In this case, complete dentures were fabricated for an edentulous patient with a skeletal class III edentulous patients by forming anterior edgeto-edge bite considering neutral zone in maxillary anterior teeth, and good aesthetic and functional results were obtained.