A 10-Step Digital Workflow for Immediate Implant Placement and Loading in Terminal Dentition Patients

To present a step-by-step approach for formulating the preoperative prosthetic design and rehabilitating patients with terminal dentition through immediate implant placement and loading using a singular design.

The proposed workflow begins with the acquisition of critical and complementary digital data, which are then registered to create a virtual patient representation. A two-dimensional smile design is subsequently converted into a three-dimensional (3D) design to determine the type of full-arch prosthesis. By utilizing the 3D models obtained from cone-beam computer-tomography data segmentation and fusing them with intraoral scan data, the prosthesis final design (singular) is established considering post-extraction soft tissue changes. Then implant planning is performed along with the selection of the necessary abutments and components. Subsequently, the provisional prosthesis is designed, and a stackable guide system is created to enable immediate implant placement and loading, leading to undisturbed soft tissue healing in accordance with the final design, which is particularly critical in FP1 restorations to preserve the existing gingival zeniths and papilla architecture.

The proposed 10-step digital workflow provides a systematic framework for selecting a singular design for full-arch implant-supported prostheses in patients with terminal dentition, by integrating current technological advancements and a remodeling prediction algorithm. Immediate implant placement and loading are guided by a facially driven prosthetic design and thorough implant planning, facilitating soft tissue healing according to the final design and ensuring outcomes that satisfy both function and esthetics.

By implementing the presented 10-step approach for rehabilitating patients with terminal dentition, a comprehensive treatment plan can be developed through systematic analysis of the acquired digital data and executed in accordance with fundamental prosthodontic and surgical principles.