Visual treatment objective-based lateral esthetics preview for implant-supported reconstruction in terminal dentition with proclined maxillary incisors

Patient: A 67-year-old woman presented with severe periodontitis-induced terminal dentition and proclined maxillary incisor. Three-dimensional facial esthetics-driven computer-assisted virtual tooth rearrangement was performed for implant-supported full-arch reconstruction. The digital workflow combines facial and spiral computed tomography (CT) scans to generate a virtual patient for three-dimensional (3D) facial analysis and obtain a visual treatment objective (VTO)-based lateral esthetic preview for virtual teeth rearrangement. Subsequently, this printed interim denture performed well in functionalization and esthetics, acted as a transitional removable denture, radiological template, and implant-supported interim denture, and guided the design of the final restoration.Discussion: Conventional methods for lateral esthetic preview, such as traditional wax rim try-in, confront difficulties in the treatment of terminal dentition, especially in the presence of proclined maxillary incisors. However, currently available software that aids information fusion and facial analysis can accurately predict soft-to-hard tissue movement and efficiently guide virtual tooth rearrangement for implant-supported full-arch reconstruction.Conclusions: The use of VTO-based lateral esthetic preview for implant-supported reconstruction improves pre- and postoperative information transfer accuracy and doctor-patient communication efficiency.