Facially driven digital workflow in full-arch implant rehabilitation. Case report on rehabilitation of severe atrophy using a facial scanner and additively manufactured rims.

The use of facial scan data with digitally designed rims facilitates a predictable facially driven treatment plan and restorative procedures for patients with severe atrophy, failing dentition, and a reduced lower facial third. This clinical report describes a digital workflow for the rehabilitation of a patient with a severely diminished lower facial third by incorporating facial scans with full-arch digitally designed occlusal rims for the vertical dimension, guided by a modified intraoral scan body (AFT Dental System; Seville, Spain). As a result, functional and esthetic parameters established through try-in of the rims can be transferred to the facial scan during the digitization process of the patient. This technique facilitates a predictable facially generated treatment plan, digital design, and manufacturing of interim prostheses in the determined vertical dimension of occlusion. On the other hand, taking a conventional facial scan with the intraoral device placed in the initial interocclusal relationship would not provide a facial reference that would allow the technical team to create a digital plan, considering key aspects such as the amount of tooth exposure at rest, the relationship of the maxillary incisal edges with the lower lip, and the distribution of the posterior planes in relation to the horizontal reference planes.