Objective: complex rehabilitations present multiple difficulties, regarding both the planification of the surgery and the design of the prothesis. A digital approach can support the workflow, as well as the degree of intraoperative precision, and improve the long-term prognosis. Methods: A surgical guide was designed for implant placement. An extensive regeneration of the upper jaw was performed with contextual implant insertion, and a delayed load rehabilitation was chosen. After four months, a second surgery and a simultaneous soft tissue augmentation was performed, and a 3D-printed temporary restoration was placed. After another two months, new dental and facial scans, smile design, and facial bite registrations were obtained. Upper and lower dentures were built using an exclusively digital workflow. Both metal substructures were passivated and cemented in one session; in the following appointment, the aesthetic and occlusal checks were carried out. During the third visit, both prostheses were delivered. Results: Careful case planning and the surgical guide made it possible to achieve primary stability and acceptable emergence profiles in an extremely reabsorbed upper jaw. Leukocyte-Platelet Rich Fibrin (L-PRF) made the extensive bone regeneration more approachable and lowered the post-operative pain and swelling, while speeding up the soft tissue healing process. During the re-entry surgery, the volumes of soft tissues were increased to improve aesthetics, and the amount of keratinized gingiva around the six implants was also increased. Smile design and facial scans have provided the means to create acceptable aesthetics and function in a few sessions with minimal patient discomfort. Conclusions: Computer-assisted implantology is a safe and precise method of performing dental implant surgery. Preliminary studies have a high degree of accuracy, but further studies are needed to arrive at a fully digital clinical protocol at all stages.

The digital transformation has revolutionized various sectors, including dentistry. Dentistry has emerged as a pioneer in embracing digital technologies, leading to advancements in surgical and prosthetic oral healthcare. Immediate loading for full-arch edentulous dental implants, once debated, is now widely accepted. This case report describes a 74-year-old patient with dental mobility and significant bone loss who was rehabilitated using a Toronto Bridge protocol on four dental implants with immediate loading. Digital planning, surgical guides, 3D printing, and precision techniques were employed. The surgery involved implant placement and prosthetic procedures. The patient reported minimal post-operative discomfort, and after four months, the definitive prosthesis was successfully placed. This case demonstrates the efficacy of immediate loading in complex dental scenarios with digital innovation, resulting in improved patient outcomes. The full digital workflow, including 3D printing and the use of modern materials, enhances the efficiency and predictability of oral rehabilitation, marking a transformative era in dental care. The integration of digital technology in all phases of treatment, from diagnosis to finalization, makes this approach safer, reliable, and efficient, thereby benefiting both patients and clinicians.

Aim: This case report aims to illustrate a clinical protocol that allows for the rehabilitation of patients requiring extensive osteotomy, simultaneous implant placement, and full-arch, screwed-in prosthetics in one session. This protocol allows for the improvement of the aesthetics and functionality of the fixed implant-supported prosthesis through the preoperative planning of all surgical procedures, including osteotomy, and of the prosthesis through the application of 3D-printing technology for the creation of surgical templates and prostheses. Methods: This case report concerns a 72-year-old patient, ASA1, who, following diagnosis, the establishment of a treatment plan, and the provision of informed consent, opted for an immediate, full-arch rehabilitation of the lower arch. The digital planning stage started with the correct positioning of the fixtures. The proper bone levels were found and used to guide the creation of the provisional screwed-in prothesis. Two templates with the same supports (landmarks/pins) were then 3D-printed: a positioning template, including a slit to assist the surgeon during the osteotomy, and a surgery template to assist the surgeon during the implants’ positioning. A screwed-in prosthesis encased in resin C&B MFH (NEXTDENT^®, Soesterberg, The Netherlands) was delivered. Minimal occlusal adjustments were performed. Results: In a single clinical session, through careful planning and the pre-operative 3D printing of a prosthesis, a temporary implant-supported prosthetic rehabilitation was possible in a case that required an extended osteotomy. Clinically, the correspondence between the virtual design phase and the final realization was consistent. At a functional level, the provisional prosthesis required minimal occlusal adjustments and the DVO values obtained in the immediate post-operative period were found to be comparable to those of the virtual design. By planning the final position of the bone and the implants in advance, it was possible to deliver a full-arch prothesis with proper implant emergence, occlusal vertical dimensions, and occlusal relationship. Conclusion: This fully digital protocol allows the clinician to preview and plan the osteotomy and implant surgery as well as the delivery of the temporary, immediately loaded, complete, fixed prosthesis in patients who are candidates for post-extraction surgery with the need for severe osteotomy.

Three-dimensional printing is rapidly growing in applied dentistry. In order to print faster, increase workflow, and minimize the consumption of resin material, it is important to use the right printer and the correct printing orientation. The objective of the present report is to analyze the flexural strength of specimens realized with two different dental light-curing resins (Keyguide and C&B) obtained from two different Digital Light Processing (DLP) 3D printers. Different printing orientations (0°, 45°, and 90°) were evaluated. 3D Builder, MeshMixer, RayWare, and Chitubox software were used to design the resin specimens. A total of 15 Keyguide and 15 C&B specimens in the shape of a rectangular parallelepiped, with dimensions of 2 mm × 2 mm × 25 mm, were obtained with the Sprintray Moonray S 3D printer, and the 15 Keyguide and 15 C&B specimens presented the same characteristics as those printed using the Moon Night printer. Prior to sample printing, a calibration protocol (tolerance test and dimensional accuracy test) was performed using RayWare software. This procedure allowed compensation for resin shrinkage or expansion, thus ensuring dimensional consistency in all printed samples. Each resin specimen, after printing and post-processing (MoonWash 2 and MoonLight 2), was subjected to a mechanical test with a universal testing machine. After breaking the specimen, the flexural strength values were recorded with computer software (Bluehill, Instron Corporation, Canton, MA, USA). According to the results obtained, the printing orientation of the specimens does not affect the flexural strength of the two materials examined. However, at the maximum load, some differences emerged for both materials printed with the Moon Night printer, depending on their build angle. Both light-cured resins tested had a higher maximum load resistance when printed with the newer Moon Night printer. This result could be due to the Moon Night printer’s better construction characteristics compared to those of the Sprintray or to issues related to the dimensional calibration of the specimens.

Three-dimensional printing is growing rapidly in applied dentistry. To print faster, increase workflow, and minimise resin consumption, it is important to use the right printer and correct printing orientation. This report aims to analyse whether different printing orientations and types of printing materials could affect the flexural strength of a series of photopolymerisable resin samples. Seven different dental light-curing resins (Keyguide, C&B, Ivory, Vertysguide, Bite, Tera, and Nextdent Cast) and a single modern digital light processing (DLP) 3D printer (Moon Night) were used for this purpose. Different printing orientations (0°, 45°, and 90°) were evaluated. The resin specimens were designed using 3D Builder 20.0.4.0, MeshMixer 3.5.0 and Chitubox software 2.0.8. A total of 15 specimens (five for each orientation evaluated) in the shape of a rectangular parallelepiped with dimensions of 2 mm × 2 mm × 25 mm were produced for each of the seven selected resin materials with the Moon Night printer. After printing and post-processing (MoonWash 2 and MoonLight 2), each resin specimen was subjected to a mechanical test with a universal testing machine. After breaking the specimen, the flexural strength values were recorded using Bluehill computer software (Instron Corporation, Canton, MA, USA). According to the obtained results, the build angle does not affect the flexural strength of the printed products, whereas the difference occurs due to the different printing materials used.