Using Digital Workflows for Full-Arch Implants: From CBCT to Final Restoration

Here at Voxel, we've made it our mission to help doctors establish digital dental workflows, achieving quick & positive ROI with the best value technology on the market. One particular area we like to focus on is the full-arch implant workflow, as doctors searching for ways to boost revenue can find a proven methodology to help them get there. With training and an investment in technology, we can help you get there!

From the initial diagnostic scans to the final prosthetic restoration, digital tools like CBCT, intraoral scanners, CAD/CAM software, and in-office milling systems have streamlined the process, improving accuracy, efficiency, and patient outcomes.

Today, we're walking you through the complete digital workflow for full-arch implants, focusing on how each step contributes to an enhanced treatment experience.. while also providing our recommendations for manufacturers we believe are innovators in each domain.

1. CBCT Imaging: The Foundation of Digital Workflow

The digital workflow for full-arch implants begins with 3D imaging.

CBCT provides a detailed 3D visualization of the patient's jaw, allowing clinicians to accurately assess bone volume, density, nerve pathways, and sinus cavities. This step is essential for precise diagnosis and treatment planning, particularly in full-arch cases where multiple implants must be placed.

Benefits of 3D Imaging in Full-Arch Implants:

• Accurate Diagnosis: CBCT scans provide detailed anatomical information, ensuring that the dentist has a comprehensive understanding of the patient's oral structures before treatment.
• Enhanced Planning: With 3D data, clinicians can plan the optimal placement of implants based on the patient’s specific bone structure, reducing the risk of complications.
• Virtual Surgical Guides: The data from CBCT can be used to create virtual surgical guides, enhancing precision during implant placement.

Recommended CBCT systems for full-arch implants

Here's just a quick list of our recommendations best suited for full-arch implant workflows. For a deeper dive, we encourage you to check out what our imaging expert, Dustin Haney, has to say for each in his complete summary: Top 5 CBCT Systems for Full-Arch Implants.

• Vatech Green 2
• DEXIS OP3D LX
• Carestream CS 9600
• Rayscan Alpha 3D
• i-CAT FLX v17

2. Intraoral Scanning: Streamlining Impressions

Following CBCT imaging, an intraoral scanner is used to capture a digital impression of the patient's mouth. This replaces traditional impression materials, offering a more comfortable experience for the patient while providing a highly accurate digital model of the soft tissues and existing dentition.

Benefits of Intraoral Scanning in Full-Arch Cases:

• Increased Comfort: Intraoral scanners eliminate the need for traditional impression trays, which can be uncomfortable, especially in edentulous (toothless) patients.
• Precision: Digital impressions are incredibly accurate, ensuring the perfect fit for temporary and final restorations.
• Time Efficiency: Digital impressions reduce chair time and allow for immediate transfer of data to the laboratory or in-office milling unit for fabrication.

Recommended INTRAORAL SCANNERS for full-arch implants

Here's another quick list of scanners best suited for full-arch implant workflows. Our resident expert on I/O scanning, Mark Bacino, weighs in on how you may want to evaluate choosing between popular scanners in the market today (besides just giving us at Voxel a call!): How to Choose the Best I/O Scanner for Your Practice.

• Medit i900
• 3Shape TRIOS 5
• Alliedstar AS260 & AS200E Wireless

3. CAD/CAM Software: Designing the Full-Arch Restoration

Once the CBCT scan and intraoral scan data are captured, CAD/CAM (Computer-Aided Design/Computer-Aided Manufacturing) software is used to design the full-arch restoration. This software allows for detailed planning of the final prosthesis, from the position and angulation of each implant to the design of the prosthetic teeth.

Benefits of CAD/CAM in Full-Arch Implantology:

• Precise Planning: The combination of CBCT data and digital impressions enables the dentist to design the ideal implant-supported prosthesis, taking into account esthetics, function, and patient comfort.
• Customizability: Each full-arch restoration is fully customized to the patient's anatomy, ensuring a perfect fit and natural appearance.
• Real-Time Adjustments: CAD software allows clinicians to make adjustments in real-time, previewing the final outcome before fabrication begins.

4. Guided Surgery: Enhancing Accuracy and Predictability

Guided surgery uses the digital treatment plan created with CAD/CAM software to fabricate surgical guides, which direct the precise placement of implants during the surgical procedure. These guides ensure that implants are positioned exactly where they were planned, minimizing the risk of error.

Benefits of Guided Surgery:

• Improved Accuracy: Surgical guides provide a physical template that ensures the implants are placed in the exact planned positions, reducing the margin for error.
• Reduced Surgery Time: By pre-planning the entire procedure, guided surgery shortens operating time, reducing patient discomfort and recovery time.
• Better Outcomes: Accurate placement enhances the long-term success of the implants by ensuring optimal alignment, bone integration, and prosthetic fit.

Often, doctors fabricate the full-arch case surgical guides through 3D printing. 

How 3D Printing Enhances Guided Surgery:

• Custom Surgical Guides: 3D-printed guides are created based on the patient’s CBCT and intraoral scan data, helping the clinician position the implants with precision. These guides fit over the patient’s gums and guide the placement of the drill at the exact angle and depth needed.
• Fast Turnaround: 3D printing allows for rapid fabrication of surgical guides, often in-house, reducing the time between planning and surgery.
• Cost-Effective: Producing surgical guides in-office via 3D printing is more cost-effective than outsourcing to a third-party lab, saving both time and money.

Recommended 3D Printers for Surgical Guides

Here at Voxel, 3D printing is the life-blood of our company. It's where we got started back in 2016, seeing how this digital technology would literally shape the future of dentistry. Today, it's hard to imagine many processes without in-office 3D printers - which typically pay for themselves in a short span vs sending to a third party.

It's fair to say, we're obsessed with 3D printers! And, this technology is constantly evolving to best serve the needs of dental practices at the fastest, most efficient rate possible. For printing surgical guides, these printers are the best value to get the job done right:

• SprintRay Pro 2
• Flashforge Focus Ultra
• LuxCreo iLux Dental Pro

5. In-Office Milling: The Power of On-Demand Restorations

One of the most significant advancements in digital workflows for full-arch implants is the integration of in-office milling. Using a chairside milling machine, dentists can fabricate temporary or even final prosthetic restorations on the same day as surgery.

In-office mills are more affordable than ever, meaning more doctors are looking into chair side milling vs sending to a third party/lab.

How In-Office Milling Works:

• Design Transfer: Once the full-arch prosthesis is designed in the CAD software, the digital file is sent to the in-office milling unit.
• Material Selection: The clinician selects the appropriate material (such as zirconia, hybrid ceramics, or PMMA) for milling. For temporary restorations, materials like PMMA are commonly used, while zirconia or hybrid materials are used for final prosthetics.
• Rapid Fabrication: The milling unit then carves out the full-arch prosthesis based on the design, creating an accurate, custom-made restoration that can be delivered to the patient on the same day.

Benefits of In-Office Milling:

• Reduced Turnaround Time: Instead of waiting days or weeks for an external lab to fabricate restorations, in-office milling allows clinicians to create and deliver prosthetics within hours.
• Enhanced Patient Experience: Patients appreciate the convenience of same-day restorations, especially in full-arch cases where they can leave the office with a complete set of functional teeth.
• Full Control: With in-office milling, the dentist has complete control over the fabrication process, ensuring that any last-minute adjustments or customizations can be made immediately.

Recommended Milling Machines for full-arch implants

Check out our quick list of milling technologies best suited for full-arch implant workflows. Watch the video from our resident milling expert, Joe Andrasko, who dives deeper into today's top choices: Introducing Voxel's Milling Line.

• For Dry Milling:
  • Roland DWX 52 Plus
  • VHF E5
• For Wet Milling (Less Likely in Full-Arch Cases, Typically Used in Individual Restorations):
  • Roland DWX 42W
  • VHF E4
• For Zirconia Pucks (Common Material Used for Full-Arch Restorations)
  • Aidite 3D Pro Zir

6. Final Restoration Placement: Precision in Action

Once the implants are placed and osseointegration has occurred, the final full-arch restoration is placed. Thanks to the digital workflow, the prosthetic framework is precisely fabricated to fit each implant position, ensuring a perfect fit and minimal need for adjustments.

Benefits of Digital Workflow in Final Restoration:

• Accuracy: The use of digital impressions, CAD/CAM software, and photogrammetry ensures that the final prosthesis fits perfectly, reducing the risk of misalignment or discomfort.
• Efficient Workflow: The seamless integration of scanning, design, and milling allows for a smoother, faster process from surgery to final restoration.

Conclusion: The Future of Full-Arch Implantology

Digital workflows are revolutionizing full-arch implant dentistry, offering unprecedented precision, efficiency, and convenience.

From the initial CBCT scan to in-office milling of the final restoration, each step in the process is designed to enhance the patient experience and improve clinical outcomes. For dentists looking to stay at the cutting edge of implantology, integrating these digital tools—particularly the adoption of in-office milling—can streamline workflows, reduce turnaround times, and deliver exceptional results.

The future of full-arch implantology is digital, and adopting these advanced workflows will help clinicians provide better care, maximize efficiency, and ultimately transform their practices.

WHERE TO GET STARTED?

If you’re in the market for a complete full arch workflows, let us help you get the right tech to get started.

Here at Voxel, we have a team of dental technology experts ready to help you find the right equipment for your practice. And, because we’re an authorized dealer of many top technology brands, including all of the brands listed today and more, we’ll be able to help you find the best solutions for your practice at the best value.

We’ve worked with thousands of dentists across the US. We know what it takes to get up and running quickly, especially with new technology. That’s why we back all of our products with a comprehensive warranty, 24/7 product support, installation, and perhaps, most importantly, online and on-site training to help get you and your staff started with your new technology as quickly as possible.

Ready to begin? Give us a call at (281) 789-7270 or fill out an online inquiry form here. We look forward to earning your business.