Occlusal Errors In Free-End Implants Using Hybrid Digital Workflow

This study evaluates occlusal errors and their influencing factors in free-end implant restorations using a hybrid digital workflow. The findings aim to provide evidence-based recommendations for workflow optimization and error reduction. This study included patients who received free-end implant restorations, with approval from the Ethics Committee. Restorations were fabricated with a hybrid digital workflow based on intraoral scanning. Key time intervals—including digital impression, model printing, model scanning, and prosthesis delivery—were recorded. Pre- and post-occlusal adjustment digital impressions were analyzed using 3D reverse engineering software. The occlusal adjustment metrics, including the average adjustment, maximum adjustment, cusp adjustment, adjustment area, and RMS value were measured. Patients were grouped based on their periodontal condition, number and position of missing teeth, type and location of edentulous arches, and the type of prosthesis and opposing teeth. Statistical analyses were conducted using the Mann-Whitney U test, Kruskal-Wallis test, and Spearman correlation analysis. 1. Periodontal condition significantly influences occlusal adjustment in free-end implant restorations. 2. The occlusal adjustment of second molar implant restorations increases with the number of missing free-end teeth. 3. Occlusal adjustments are significantly correlated with the duration of the hybrid digital workflow, particularly the model printing and model scanning-to-prosthesis delivery intervals. In the hybrid digital workflow, it is advisable to optimize the prosthetic procedures and reduce the time intervals between model printing, model scanning, and prosthesis delivery to decrease occlusal errors.