Digital Workflow With a Triple Scanning Technique for Implant Rehabilitation in the Esthetic Zone

This article describes the case of a partially edentulous patient who had undergone template-guided implant placement and was treated using a triple digital scanning protocol that allowed for CAD/CAM prosthodontic rehabilitation in a complete digital workflow. At the impression appointment, the provisional implant-supported screw-retained prosthesis was digitally scanned both intraorally (first scan) and, after removal, extraorally (second scan). After the second scan, scan bodies were placed intraorally and an implant-level digital impression was taken (third scan). The three standard tessellation language (STL) files derived from the three digital scans were imported in a CAD software and superimposed into one file that contained all of the information from the implant 3D position, prosthesis contours, and transmucosal part of the peri-implant soft tissues. The superimposition of the three STL files led to one master file to serve as a blueprint for the definitive prosthesis. The definitive monolithic zirconia prosthesis was CAM copy-milled, externally stained, and inserted. The patient was satisfied with both the esthetic and functional outcome and the minimally invasive, time-efficient, two-visit restorative protocol. In summary, this case report illustrates a technique for a complete digital workflow in an implant rehabilitation for the replacement of multiple missing teeth in the esthetic zone in two visits.