Background: The aim of this case report is to describe the innovative concept of a prototype use in a digital implant workflow. A prototype is required for simultaneous evaluation of the accuracy of a dental impression and esthetic and functional parameters before final framework realization.

Case Description: Three digital impressions were obtained to create a master file, which contained information on the 3-dimensional (3D) position of the implant, the gingival architecture, and the esthetic and functional features of the provisional restoration. A stereolithographic master model (SMM) featuring implant analogs was 3D printed. Two prototypes were realized with the use of 2 different modalities. The first resin prototype (A), which lacked implant connections, was produced with the use of a certified digital workflow process. The titanium connections were luted onto the SMM. The second resin prototype (B), considered experimental, was a single piece with milled implant connections. Both prototypes were tested in the patient by means of visual inspection, finger pressure testing, screw resistance testing, and periapical radiography. In the case of accurate fit of prototype A or B on the SMM and misfit in the patient, the impression should be invalidated. For prototype B, in the case of proper fit in the patient and misfit on the SMM (because of the occurrence of an error during 3D printing, incorrect analog position, or both), the impression should be validated, but the model should be adapted.

Conclusions And Practical Implications: The use of a prototype allows the clinician to simultaneously test implant position and esthetic and functional parameters. However, a single-structure prototype could be preferable for the identification of impression inaccuracy.

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http://dx.doi.org/10.1016/j.adaj.2018.04.026DOI Listing

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