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Immediate Implant Placement and Loading in the Esthetic Zone Using a Four-Dimensional Virtual Patient Protocol: A
Efstathia Afrati1, Nikolaos N Giannakopoulos1,2, Andreas Krokidis3
1Prosthodontics, National and Kapodistrian University of Athens, Athens, GRC.
Cureus
|June 15, 2026
Summary
This study introduces a 4D virtual patient data technique for precise anterior dental implant placement. It integrates real-time jaw movements for improved prosthetic-driven rehabilitation in the esthetic zone.
Area of Science:
- Dentistry
- Prosthodontics
- Implantology
Background:
- Immediate implant placement and loading in the anterior esthetic zone present complex prosthetic challenges.
- Managing interferences during mandibular excursive movements is critical for successful outcomes.
Purpose of the Study:
- To present a novel technique for obtaining four-dimensional (4D) virtual patient data.
- To detail a method for prosthetically driven anterior implant rehabilitation using digital workflow.
Main Methods:
- Acquisition of 4D virtual patient data by integrating cone beam computed tomography, intraoral/face scans, and optical jaw motion tracking (JMA Optic System).
- Superimposition of multi-source data using Exocad software, with alignment based on remaining dentition.
- Utilizing a CAD/CAM-fabricated surgical guide and a digitally designed provisional restoration for accurate clinical transfer of the digital plan.
Main Results:
- Successful integration of dynamic jaw movement data with static imaging and scanning for comprehensive virtual planning.
- Facilitation of precise implant placement and immediate provisional restoration according to the digital simulation.
- Demonstration of a reproducible method for transferring digital treatment plans to clinical application.
Conclusions:
- The presented 4D virtual patient data technique enhances prosthetic planning for immediate anterior implants.
- This digital workflow supports a prosthetically driven approach, improving the predictability of esthetic zone restorations.
- The method allows for accurate clinical reproduction of planned prosthetic positions, optimizing implant rehabilitation.