Digital workflow in implant prosthodontics: The critical aspects for reliable accuracy

INTRODUCTION: This paper is a comprehensive treaty about the variables that influence the transfer of the position of an implant to the laboratory when using a digital workflow. OBJECTIVE: The aim is to provide operators and manufacturers with a guide on how to improve certain aspects of the digital workflow specific to the fabrication of implant-supported restorations. OVERVIEW: It addresses intraoral scanning issues and CAD software issues. In the former, the variables that play a part in the quality of the scan file are investigated: the implant scan body, the IOS and the operator. For the latter, instead, the focus is on those aspects that still today may create inaccuracies in the workflow and in the final product being fabricated: the identification of the specific implant placed in the patient and the generation of a virtual model with the representation of that implant platform correctly positioned in the three dimensions of space. Suggestions and recommendations are given to improve the control on the quality of the digital workflow's output. CONCLUSION: In a digital workflow for the fabrication of an implant-supported restoration, the selection and use of the implant scan body, the use of an effective scan strategy and the appropriateness of the best fit function in the CAD software, that is, the procedure of superimposing the library of geometric shapes of the ISB linked to the implant with the shape acquired intraorally, are variables that can influence the positional precision of the FDP. CLINICAL SIGNIFICANCE: Fully understanding the importance of the information enclosed in the ISBs themselves can be crucial in the digital workflow. A proper ISB's selection, a correct scan of the ISB's shape and an accurate CAD superimposition of the ISB's library can lead the clinician to reduce the variables that affect the final result in daily practice.