Case studies

The case report demonstrates a fully digital workflow used in the design and production of clear aligners for an orthodontic treatment.

A 52-year-old patient presented in our clinic for implant consultation. The patient’s medical history was noncontributory. Clinical & radiographic examination revealed failing dentition as a result of periodontal disease and recurrent carries. Additionally, the patient had excessive gingival display upon smiling.

The patient is presented with a loose-fitting upper denture. Upon extraction of her dentition one year earlier, a temporary denture was made by another practice. The patient chose not to wear the temporary denture due to retention complaints. Upon consultation it was decided to place four implants in the upper jaw.

A medically healthy and non-smoker 65 years old female applied for treatment of partial edentulism at maxilla. Accordingly, her major complaints were loss of function and displeasing appearance at non-esthetic and esthetic zone, respectively.

The patient is a 39-year-old male with no remarkable medical history or condition. The patient looked to achieve his specific aesthetic goals with the restorations, in terms of shape and shade of the teeth. He had previously had composite restorations on his teeth that he was not satisfied with.

53-year-old female in good overall health with a non-contributory medical history. Patient wished to have a natural looking upgrade to her teeth without the result looking too white. She was not interested in treating the lower teeth.

A 78 -year old patient needed replacement of her existing lower broken implant retained overdenture. Dental history revealed multiple excessive fractures and repairs of the broken existing denture, which appeared as a result of flexural fatigue for over 10 years.

The case demonstrates a full digital workflow and direct integration between the 3Shape TRIOS Design Studio and the DGShape DWX-42W mill to allow for in house manufacture of the restoration.

A 79-year old male patient with moderate to advanced bone loss affecting many of his upper and lower teeth. The treatment goal was to rehabilitate the upper arch with a combination of crowns and implant retained restorations.

26-year-old male patient presented with a traumatic injury to the tooth 11, sustaining a complicated crown-root fracture. A modeless digital workflow was used for the immediate implant placement and restoration. The case study describes the modeless digital workflow for an immediate implant placement and restoration.

A male patient in his mid-60s presented with a chief complaint about the esthetics of his anterior maxillary and mandibular teeth (crowding, severe tetracycline staining). Proposed treatment involves placing milled monolithic lithium disilicate (IPS e.max CAD, Ivoclar Vivadent) full-coverage crown restorations on seven maxillary teeth (#6 through #12) and six mandibular teeth (#22 through #27). Workflow is completely digital.

A patient's tender tooth 46 has a deteriorating large MOD composite resin filling with a lingual crack visible under high magnification. The treatment goal was to create an aesthetic crown that met all clinical requirements and accommodated the patient’s parafunction and intermittent occlusal splint usage.

Case describes a male, fully edentulous patient in need of a new set of dentures. The patient’s dentition became terminal due to a past drug addiction several years ago. He has been rehabilitated with numerous sets of conventional dentures in the past.

The case describes 44-year old male patient in need of a restoration of the mandible using a full-arch monolithic restoration on six implants.

The case study describes the digital workflow for an implant restoration of the second left maxillary premolar.

A 14-year old patient presented with a Class III profile, Class III canine relationship on the left side, and ClII-ish on the right side. There was a crossbite of the upper laterals, ectopic canines, lower incisor proclination, dental midline shift, and minimal overbite and overjet.

The case describes the replacement of a more than 15-year old implant retained denture using a digital workflow developed by Dr. Faber.

The case describes 44-year old male patient in need of a restoration of the maxilla using a full-arch fixed prosthesis on six implants.

Case describes an 80-year old patient with root fractures and a four-wall boney defect. Grafting and implants were not an option. The case study describes the digital workflow for creating a zirconia bridge to replace teeth #6-12.

Case describes how with the help of technology, a patient who ordinarily may not receive care is able to. Using 3Shape design software enabled the design and printing of dentures at a lower cost in an easy to fabricate method. The case study describes the digital workflow used for creating and 3D printing a denture.

Case describes a patient suffering from parodontitis in need of a full denture. An intraoral scan and Smile Design were used to design the full denture. The case study describes the digital full arch workflow for the planning and production of a denture.

Case describes a prosthodontic restoration of the lower right quadrant using onlays and a single lithium disilicate crown. Planning and workflow were model free and performed using 3Shape TRIOS and Dental System software. The case study describes the model free digital workflow used in the planning, placement and prosthodontic restoration of the lower right quadrant.

"On clinical examination, we can see a lingual crack and an occlusal-mesial leakage of the amalgam. Due to the large size of the defective restoration, the treatment choice is to use an indirect bonded restoration – veneerlay type," Dr. Édouard Lanoiselée. The case study describes the digital workflow for planning and placement of an e.max veneerlay on the lower left first molar.

Case describes a prosthodontic restoration of the lower right first premolar with a screw-retained implant supported crown. Planning driven by TRIOS implant scanning, software and 3Shape scan bodies. The case study describes the full digital workflow in the planning, immediate guided surgical placement and the prosthodontic restoration of the lower right first premolar.

Patient complained of pain and mobility from the right first premolar (tooth 44). Examination revealed class 2 mobility and deep periodontal pocketing localized to the tooth. The case study describes the full digital workflow in the planning, immediate guided surgical placement and the prosthodontic restoration of the lower right first premolar.

Patient is a 26-year old female that presented with 6 existing, 3-year old porcelain veneers and was unhappy with the appearance. They were too labially placed with a significant midline cant and the canines flared. The decision was made to replace the existing 6 porcelain veneers with 10 all ceramic veneers. The procedure was performed using a digital workflow including Smile Design and bis-acryllic temporary mock-up.

A 26 -year-old female (TV personality) looking to improve her smile. As a celebrity, the patient’s goal is to obtain the best smile possible without fixed appliances due to her public profile. The patient was presented with a treatment plan consisting of no. 12 clear aligners to be changed every two weeks. She was able to view the treatment on a video (3Shape Ortho Analyzer) including debonding.

Patient presented with mobile upper anterior teeth which protruded facially. Treatment called for a screw retained 4-unit layered zirconia bridge supported by 2 Co-Axis implants.

Patient diagnosed with Squamous Cell Carcinoma of his right premaxilla and nasal cavity days before his restorative treatment is scheduled. The successful case documents that the 3Shape TRIOS intraoral scanner was capable of scanning both teeth and soft tissue (a resected maxilla) with high accuracy and precision.

Female patient aged 62. The patient is healthy but with failing dentition in the upper maxilla, 11, 21, 12, 22. The patient would like to improve her functionality and oral esthetics.

Patient in his early 80s with a chief complaint of recurrent pain, discomfort and swelling from his lower dentition. Treatment called for provision of an immediate implant retained fixed provisional bridge.

Patient is suffering from the continuous decimation of her crown on the central incisor. Remaining stump has subgingival margins and the typical appearance of having suffered continued leaks.

This case describes an aesthetic and functional rehabilitation of an upper premolar. Dr. Nelson used the TRIOS® intraoral scanner and the Implant Studio® software for the implant planning and surgical guide design as well as Dental System™ for the making of the final prosthesis. Dr. Nelson says: “In the case presented here, the combination of TRIOS® and Implant Studio® with Dental System™ to manufacture the prosthesis has generated a predictability on the execution, from the correct positioning of the implant to the restoration placement.”

Male patient, 72 years old, with a 3 months prior extract from failed root canal treatment on supported bridge 13–22. Patient would like a fix prosthodontics for missing teeth.

Patient is 32-year old male suffering from multiple loss of teeth due to severe dental caries. Exposed root rests were all unusable as abutment teeth and remaining teeth were erupted and not in their own occlusal position. The treatment plan was divided into five phases. Dr. Lee says that “with the advent of dental CAD/CAM technology like Implant Studio®, we can now anticipate the position of the implants before surgery. And with this, immediately loaded implant prosthesis are much more precise and easier to place."

Dr. Lee has been chief dentist at the Jungplant Dental Office in Seoul since 2010. Many of Dr. Lee’s patients are elderly. This has provided Dr. Lee with extensive experience in working with full-mouth rehabilitation and partially edentulous cases. The treatment plan called for three phases. Each involved extensive surgery and restorative design. Dr. Lee says, “Implant Studio enables me to intuitively plan a surgery based on the prosthetic considerations. As this case illustrates, being able to virtually place and verify the implant position for the final prosthesis prior to surgery is extremely valuable.”

Dr. Tan presents three different types of cases.
Each case uses 3Shape Implant Studio® and TRIOS® intraoral color scans for the implant planning and surgical guide design.

- Patient 1 is an upper lateral incisor replacement;
- Patient 2 is upper central incisor tooth replacement;
- Patient 3 is a patient requesting the replacement of teeth 46 and 47.

Female patient aged 42. Patient wants to replace old PFM crowns on #12, #22 as they have poor margins as well as close the gap between teeth #11 and #21. Upon stabilizing patient’s periodontal tissue, orthodontic treatment using a clear aligner created with 3Shape OrthoAnalyzer would be applied to close gap, a single visit restoration would be used to replace PFM crowns after.

A 70-year-old patient presented with a diastema and failed composite restorations to correct excessive tooth wear and incisal chipping on teeth #8 and #9. The risks of working in the aesthetic zone without a reduction guide are either under- or overprepping the natural teeth. One solution would be a virtual 3D-printed reduction guide that is delivered with the 3D-printed diagnostic wax-up model. Another solution would be to design the intraoral scanner software with the ability to compare the preparation to the virtual diagnostic wax-up and identify areas that are underprepared. Digital technologies eliminate the guesswork and inherent inaccuracies of analog processes and improve clinical workflows and efficiencies.

Female patient in her late 70’s, healthy, presented for an urgent appointment due to a broken anterior tooth. The patient has a Class 2 Div. 2 dentition with a very deep bite and traumatic occlusion. Her remaining upper anterior teeth have advanced palatal wear and chipping of the anterior edges. The patient wears a lower partial denture which was recently replaced. She chose to proceed with the e.max milled crown due to time constraints and her need for a stronger restoration. She agreed to consider a comprehensive treatment approach.

A 56-year-old female edentulous patient was referred after two mandible implant placements. For a completely edentulous patient, a complete denture is chosen as the main prosthetic treatment option. The mucostatic concept protocol should be considered and followed during digital scanning. This digital protocol allows for all the clinical steps to be performed in a single visit. The treatment plan called for a maxillary complete denture and implant-retained overdenture in the mandible.

"The high accuracy, consistency and productivity achieved using 3Shape systems has enabled CMRDental Laboratories to develop a new business model to providing greater value to their customers while increasing their productivity potential,” Matt Roberts, CMRDental Laboratory.

“3Shape is well ahead of the pack…. With such pace and diligence, I am sure that in the near future 3Shape will enable laboratories to perform practically 100% of their lab work digitally”. David Garcia, Dental Laboratory Garbident.

The patient is a middle-aged man who had an old fibre-reinforced anterior bridge. The abutment teeth of the old bridge had severe caries and the structures of the bridge had also reached the end of their lifespan. The bridge was removed. Specialist Juha-Pekka Lyytikkä from the dental clinic Hammas-Pulssi extracted the hopeless teeth and placed three Xive 3.8 mm implants for the patient (areas of #14,12, 22). When the healing period was over, the construction of the final prosthesis was started.

CDT, Daniel Alter presents the protocol for designing a screw-retained bridge using 3Shape Dental System.