Al-enhanced Dynamic Virtual Patient Workflow for Full-arch Implant Rehabilitation

Accurately recording implant positions and maxillomandibular relationships in completely edentulous patients for the fabrication of fixed implant-supported immediate prostheses presents a challenge. This study aimed to introduce a fully digital workflow incorporating artificial intelligence (AI) technology and a dynamic virtual patient to create a screw-retained, full-arch implant-supported prosthesis for a completely edentulous patient. Virtual surgical planning was conducted using digital software (3Shape dental system, 3Shape, Copenhagen, Denmark) that integrates intraoral mucosal information, anatomical images of bone tissue and the radiographic guide based on radiopaque markers of the radiopaque guide. After this, immediate implant-supported fixed complete-arch dentures (IFCDs) were fabricated based on the alignment of intraoral scans and the extraoral scans of the implant position with the scan bodies and preoperative and postoperative CBCT images. Digital impressions of interim and mucosal contours, CBCT images, facial scans and mandibular motions of the patients were collected to construct a dynamic virtual patient. The craniomaxillofacial complex and mandible were automatedly segmented using 3D Slicer via the deep learning system. Subsequently, a definitive restoration was fabricated, and the patient expressed satisfaction with the functionality, aesthetics and passive fit of the IFCDs. This technical procedure presents a digital registration method using AI technology to accurately capture the aesthetic features and maxillomandibular relationship and ensure a passive fit, potentially improving aesthetics and functionality and maintaining the long-term stability of peri-implant soft and hard tissues.Keywords: digital workflow, implant-supported full-arch prosthesis, virtual patient.