Digital workflow for reconstructing the biomechanics of the masticatory apparatus in implant-supported prosthetics in edentulous patients

Digital transformation of the algorithm of implant prosthetics includes the following steps: planning the spatial position of implants in the jawbone; making a surgical guide for real positioning of the virtual localization of implants; taking an optical impression; creation of a framework and/or the implant prosthesis itself. However, the above digital chain lacks an important step of creating a new dynamic stereotype of the patient's masticatory apparatus biomechanics that should take into account its individual characteristics. In this situation, a digital workflow can help with the reconstruction of the biomechanics of the masticatory apparatus. The aim of the study was the clinical testing of the digital workflow for reconstructing the biomechanics of the masticatory apparatus in implant-supported prosthetics in edentulous patients. Digital modeling of the occlusal surface of artificial dentition was carried out in 82 patients (28 men, 54 women) aged 54 to 83 years (mean age 73.9 ± 4.9 years). In this case, the electronic axiograph CADIAX 3 diagnostic (GAMMA Dental), virtual articulators GAMMA Reference SL and AmannGirrbach Artex CR in the Exocad galway 3.0 and Zirkonzahn.Software program were used. X-ray cephalometric analysis was also used, which was carried out in the GAMMA and OrthoLine programs. The following stages have been introduced into the technological chain of prosthodontic treatment: digital registration of the lower jaw biomechanics in combination with the spatial construction of the occlusal plane with X-ray cephalometric analysis; manufacturing of the final prosthesis copying it according to the temporary CAD/CAM prosthesis, with digital axiography, in particular, digital modeling of the occlusal surface of artificial teeth. This approach, providing a high survival rate of supporting implants (97 %) and implant prostheses (98.1 %), ease of use, contributed to the achievement of a high level of patient quality of life (scores on the GOHAI scale after treatment = 56.5 ± 10.0) associated with prosthetics.