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.

Using the neutral zone concept can increase the stability of the prosthesis. In this case, bimaxillary denture were fabricated using the neutral zone in a patient who had alveolar ridge resorption and inwardly positioned lip. This condition was unfavorable for obtaining stability of the denture, so the force involved in denture had to be minimized. There were differences in the tooth arrangement and shape of the polished surface between the definitive denture made using the neutral zone impression technique and the provisional denture made without using it.

Using the neutral zone concept can increase the stability of the prosthesis. In this case, bimaxillary denture were fabricated using the neutral zone in a patient who had alveolar ridge resorption and inwardly positioned lip. This condition was unfavorable for obtaining stability of the denture, so the force involved in denture had to be minimized. There were differences in the tooth arrangement and shape of the polished surface between the definitive denture made using the neutral zone impression technique and the provisional denture made without using it.

Using the neutral zone concept can increase the stability of the prosthesis. In this case, bimaxillary denture were fabricated using the neutral zone in a patient who had alveolar ridge resorption and inwardly positioned lip. This condition was unfavorable for obtaining stability of the denture, so the force involved in denture had to be minimized. There were differences in the tooth arrangement and shape of the polished surface between the definitive denture made using the neutral zone impression technique and the provisional denture made without using it.

Using the neutral zone concept can increase the stability of the prosthesis. In this case, bimaxillary denture were fabricated using the neutral zone in a patient who had alveolar ridge resorption and inwardly positioned lip. This condition was unfavorable for obtaining stability of the denture, so the force involved in denture had to be minimized. There were differences in the tooth arrangement and shape of the polished surface between the definitive denture made using the neutral zone impression technique and the provisional denture made without using it.

Using the neutral zone concept can increase the stability of the prosthesis. In this case, bimaxillary denture were fabricated using the neutral zone in a patient who had alveolar ridge resorption and inwardly positioned lip. This condition was unfavorable for obtaining stability of the denture, so the force involved in denture had to be minimized. There were differences in the tooth arrangement and shape of the polished surface between the definitive denture made using the neutral zone impression technique and the provisional denture made without using it.

Immediate implant placement and restoration have the advantage of shortening the treatment period and maintaining aesthetics until final restoration. However, single implant restoration in the maxillary anterior region may be aesthetically difficult, and surgical trauma delivered to soft and hard tissues during implant placement may affect future aesthetic results. In order to obtain predictable results during anterior implant placement and restoration, surgery and restoration plans must consider the height of the interdental bone, characteristics of the gingiva, and morphological characteristics of the patient’s teeth. In this case, we attempted to reproduce the emergence profile and stabilized soft tissue through gingiva modification and digital impression of a labially placed maxillary anterior implant in a patient who desired porcelain fused-metal (PFM) restoration due to economic issues.