The aim of the study is to evaluate the occlusal contact distribution in digitally fabricated implant-retained fixed partial dentures in mandibular Kennedy Class II patients before and after artificial intelligence bite optimization.
Patients with a unilateral mandibular distal extension area (Kennedy Class II partially edentulous mandibular arch) and who are indicated for the insertion of 2 implants.
Fully dentate opposing maxillary arch or restored with a suitable, well constructed fixed prosthesis.
The remaining teeth should be in good periodontal health, with no signs of inflammation or movement.
The edentulous area should be covered by a healthy, firm mucoperiosteum, with no or minimal tissue undercut.
Patients with psychological or mental disorders.
Patients with insufficient interarch space.
Patients with parafunctional habits, such as bruxism.
After the healing phase and exactly before the prosthetic phase, if the inserted implants showed any signs of peri-implantitis or aggressive crestal bone resorption, then this case will be excluded and replaced with another case.
Sequential
After
Procedure/SurgeryThe data acquisition will take place by scanning the patients using Medit intraoral scanner. Then, the scanned stls will be imported in 3shape software version 2024 and bite optimization module in it will be run. It automatically recalculates the position of the bite relation using its integrated AI. After that, the resulted STLs will be exported and re-imported to ExoCAD software to design the prostheses.
Before
Procedure/SurgeryThe recruited patients will be screened for proper bone architecture and CBCTs will be taken for proper virtual implant planning. Two implants will be placed in the edentulous span in all participants. All surgical steps will be held according to standard protocol. After the implant osseointegration period, the prosthetic phase will start with implant exposure and placement of multiunit abutments. After gingival healing, intraoral scans for the implants timing using abutment level scan bodies will be taken. Then, the fabrication of implant-retained fixed partial denture will be done with a fully digital workflow.
Occlusal contact distribution
The 1ry outcome will be assessed on the day of the prosthesis delivery. First, the reading of the occlusal contact distribution will be taken by using the T-scan device before seating the prosthesis intraorally. Then, the retained fixed prosthesis will be seated on the implant abutment, and the prosthetic screw will be screwed to the optimum torque. Another reading of the occlusal contact distribution will be taken by using the T-scan device after seating and torquing the prosthesis intraorally. Finally, the screw access channels will be closed by flowable resin composite material.
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