Redefining Edentulism:

When a 63-year-old patient presented at Dr. Mathieu Rousset’s clinic, the diagnosis was clear—and challenging.

The maxillary arch was compromised by fractured roots, failing fixed prostheses, and recurrent decementation. The remaining dentition was no longer viable, and the patient’s quality of life was suffering.

In today’s digital age, the treatment of complete edentulism is no longer defined by analog impressions and lengthy lab turnarounds. It’s defined by precision, speed and collaboration – powered by technologies like intraoral scanning, photogrammetry and 3D printing. Dr. Rousset’s case exemplifies this transformation.

Dr. Rousset chose to move forward using the All-on-4 method, which restores function and aesthetics using four implants to support a fixed prosthesis.

However, this type of workflow relies on the use of modern technologies, and demands precision, coordination, and a deep understanding of both surgical and prosthetic principles.

Here are the steps Dr. Rousset took, including the tools he used for each phase of treatment (to get an in-depth case breakdown, download the full clinical case here.
 

1. Data acquisition and planning

• Intraoral scanning with the Imprevo intraoral scanner captured a detailed digital impression of the dental and gingival tissues, as well as the occlusion.
• A CBCT scan was captured to obtain the DICOM file of the bone structures
• Both datasets were merged in DTX Studio™ Clinic, enabling virtual extractions and AI-generated wax-ups within seconds.
• The entire plan was shared with the laboratory (Genesis, Bordeaux), to create another wax-up that will be used throughout the treatment plan.

2. Guided Surgery with Stackable Guides

• The wax-up was imported into Blender to design stackable surgical guides – metal guides were selected for their rigidity and stability

Stackable guide creation
 

• The surgical sequence included flap retraction, tooth extraction, and implant placement—all performed in a single session using the Thommen Medical guided surgery kit.

3. Photogrammetry for Precision

• ICam4D photogrammetry captured the exact position and orientation of the implant interfaces.
• The data was merged with soft tissue and occlusion information from the intraoral scan.
• This ensured a passive fit for the final prosthesis and eliminated the need for traditional impression materials.

4. Chairside 3D Printing

• The provisional bridge was designed and uploaded to SprintRay Cloud where it was printed in-office using SprintRay Pro2. The bridge was printed and ready in under two hours – including post-processing and finishing.
• Rosen Screws were used to secure the bridge, eliminating the need for a Ti base and bonding, while improving force distribution and reducing fracture risk.

5. Final Prosthesis Fabrication

• After six weeks, a second digital impression was taken with the provisional bridge in place.

• The final bridge featured a titanium framework screwed directly onto variomulti abutments.

• A deocclusion splint was printed for installation day, and the final prosthesis was delivered in just two sessions: impression and placement.

“These technologies are merely tools—their success depends on the hands that use them,” says Dr. Rousset. “Mastery of the digital workflow and close collaboration with the prosthetist are essential.”

Outcome: A new standard in edentulism treatment with digital dentistry

This case exemplifies how a fully digital workflow—combining intraoral scanning, guided surgery, photogrammetry, and 3D printing—can transform the treatment of complete edentulism. The result was a predictable, efficient, and patient-centered solution delivered in record time.

While technology plays a critical role, clinical expertise and collaboration remain essential. As Dr. Rousset emphasizes, these tools are only as effective as the hands that use them. With the right protocol and the right team, even the most complex cases can be performed successfully and with confidence.
 

Want to read the full clinical case? Download it here.