Joc Jernigan, Gregori M Kurtzman
Implant-supported overdentures provide predictable improvements in retention, stability, function, and patient satisfaction compared with conventional complete dentures. However, conventional prosthetic workflows may require multiple impressions, casts, jaw relation records, and laboratory procedures. Although digital dentistry has simplified many restorative procedures, complete-arch implant scanning remains challenging because edentulous arches provide limited stable landmarks for image stitching. This article describes the clinical application of the ArchBridge™ digitally integrated workflow (ROE Dental Laboratory, Independence, Ohio) system as a fully digital, model-free workflow for fabrication of an implant-supported overdenture that can be utilized as a removable or fixed prosthesis. Following placement of definitive LOCATOR® (Zest Dental Solutions, Carlsbad, CA) abutments, uniquely identifiable ArchBridge™ scan bodies were used to digitally register implant position and orientation. The existing overdenture was relined with light-body polyvinyl siloxane and scanned extraorally, and scans of the opposing arch and interocclusal relationship completed the digital record. These datasets were merged to preserve the patient's established tooth arrangement, vertical dimension of occlusion, occlusal relationships, esthetics, and soft tissue contours during design of the definitive prosthesis. The definitive overdenture was fabricated digitally, with the retentive housings incorporated at the laboratory using a proprietary patent-pending processing technique that eliminates the need for poured models and chairside housing pickup. The ArchBridge™ workflow integrates implant registration and the patient's previously validated prosthetic information into a comprehensive digital dataset. This approach reduces reliance on conventional analog procedures while allowing the laboratory to fabricate the prosthesis and process the attachment housings directly from digital records. An additional advantage is the creation of a permanent digital archive that may facilitate subsequent repair, duplication, replacement, relining, or conversion to a fixed implant-supported restoration without repeating many conventional clinical procedures. The ArchBridge™ workflow provides a completely digital, model-free approach to implant-supported overdenture rehabilitation. By combining digital implant registration, preservation of an existing clinically validated prosthesis, and laboratory processing of the attachment housings from digital records, the technique can simplify clinical and laboratory procedures while maintaining established prosthetic parameters. Further clinical studies are needed to quantitatively evaluate accuracy, treatment efficiency, patient outcomes, and long-term prosthetic performance.