Immediate Implant Placement and Loading in the Esthetic Zone Using a Four-Dimensional Virtual Patient Protocol: A Technical Report

Rehabilitation of the anterior region requires careful prosthetic planning in cases of immediate implant placement and loading due to the complexity of prosthetically driven restoration in the esthetic zone. The management of interferences during mandibular excursive movements remains critical. A technique is presented for obtaining four-dimensional (4D) virtual patient data, where the 4D component refers to the integration of real-time mandibular movements using an optical jaw motion tracking system. Cone beam computed tomography records, intraoral and face scanning and dynamic jaw motion tracking data, including border movements, which are obtained from JMA Optic System, are superimposed using Exocad software, while data alignment is achieved using the remaining dentition as reference structures. This report describes a step-by-step method to transfer the digital treatment planning simulation into the patient’s mouth using a computer-aided design/computer-aided manufacturing (CAD/CAM)-fabricated surgical guide for implant placement and a digitally designed provisional restoration to facilitate clinical reproduction of the planned prosthetic position, supporting a prosthetically driven approach to anterior implant rehabilitation.