Page 21 - JCTR-10-5

Journal of Clinical and Translational Research 2024; 10(5): 283-290

Journal of Clinical and Translational Research

Journal homepage: http://www.jctres.com/en/home

CASE REPORT

Computer-guided implant surgery and tooth-mirroring digital workflow

to treat an esthetically compromised clinical case

Claudio Cirrincione*
Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy

ARTICLE INFO ABSTRACT

Article history: Background: In multidisciplinary dentistry, it is common to observe clinical cases that present
Received: July 1, 2024 multiple complications at the end of orthodontic therapy, such as differences in gingival height,
Accepted: October 8, 2024 alterations in size and shape of the teeth, and reduced residual spaces for implant therapies.
Published Online: October 24, 2024 Aim: The aim of the study was to solve an esthetic case with the help of digitally assisted prosthetic
and surgical design.
Keywords: Methods: A young patient had been treated orthodontically for the agenesis of tooth 12 and the
Computer-guided implantology conoid shape of tooth 22. Previous therapy consisted of opening the space for tooth 12 by positioning
Surgical diagnosis and design software a Maryland-type composite bridge, followed by reconstruction with a composite of tooth 22.
Surgical guide Various composite reconstructions on teeth 11 and 21 were no longer adequate. Furthermore, both
Artificial intelligence elements had discordant coronal axes, the diastema was observed at the incisal level, and tooth 21
Lithium disilicate veneers was approximately 1 mm longer than tooth 11. Radiographic analysis revealed that the roots of
teeth 11 and 13 converge, providing sufficient space for the insertion of a small-diameter implant.
*Corresponding author: An intraoral scan and cone-beam computed tomography (CBCT) were performed; both data files
Claudio Cirrincione were merged using surgical design software. A surgical guide was developed for the insertion of
Department of Experimental and Clinical an implant in site 12. After insertion, the composite bridge, which was no longer suitable, was
Medicine, University of Florence, Florence, removed and a new temporary metal-composite Maryland bridge was positioned. Using an
Italy artificial intelligence tool of the design software, tooth 22 was isolated, mirrored, inserted in site
Email: claudiocirrincione1@gmail.com 12 to reproduce the gingival profile, and subtracted from the digital impression. A technician then
copied this emergence profile to build a zirconia prosthetic crown to be screwed on the implant.
© 2024 Author(s). This is an Open-Access Teeth 22, 11, and 21 were restored with a lithium disilicate crown and two veneers, respectively.
article distributed under the terms of the Results: The initial digital design and the use of a guided surgery procedure allowed for the insertion
Creative Commons Attribution-Noncommercial of a small diameter implant without damaging the roots of the adjacent teeth. The prosthetic design
License, permitting all non-commercial use,
distribution, and reproduction in any medium, procedure, using the digital tools of the design program, made it possible to standardize and create
provided the original work is properly cited. symmetrical gingival profiles of teeth 12 and 22. The overall composition was completed by the use
of minimally invasive adhesive prosthetic techniques on teeth 11, 21, and 22.
Conclusion: Digital resources have become essential tools for dental professionals. The knowledge
and use of technologies like intraoral scanning and CBCT, combined with various innovations such
as artificial intelligence in prosthetic and implant design software, enable dentists to manage even
the most complex interdisciplinary clinical cases with greater confidence.
Relevance for Patients: Digital techniques are now widely used across all fields of dentistry. This
has led to the need for operators of all ages to adjust their decision-making process compared to
traditional techniques. These new techniques have also improved communication with patients,
allowing the dental team to have a clearer understanding of the clinical path to follow and
consequently offer their patients precise dentistry solutions.

1. Introduction
In the 21 century, having a radiant smile has become increasingly important.
st
A smile characterized by white, perfectly aligned teeth that are proportionate in size
DOI: https://doi.org/10.36922/jctr.24.00035