Available online 14 April 2024

This dental technique article updates the 3-dimensional (3D) virtual patient digital workflow by introducing the space-time information acquired with jaw tracking motion. The direct digital procedure involved scanning the interim prostheses, creating virtual casts, and transferring the digital facebow, virtual articulation, and jaw-tracking motion. All 3D files and records from the intraoral scanner, cone beam computed tomography, extraoral scanner, and jaw tracking motion were superimposed using existing teeth as the connecting link in all data sets and adopting the best-fit alignment. The main advantages of the technique were creating a 4-dimensional virtual patient and standardizing the introduction of clinical space-time information (the fourth dimension) beyond the static condition.

To demonstrate the digital shift from a 3D to a 4D virtual patient, a patient who had received implant surgery for a complete maxillary arch and an immediate implant-supported interim prosthesis is presented. A direct digital procedure was performed involving scanning the interim prosthesis, creating virtual casts, transferring the digital facebow, and using virtual articulation and jaw-tracking motion.

The devices used and subsequent format files generated included an IOS (iTero Element Flex;

The presented approach allowed the clinician and dental laboratory technician to follow a simplified procedure to digitally construct the virtual patient in time and space, producing a 4D virtual patient. The JTM device was selected based on the accuracy of the acquired data as reported previously.5

The present protocol collected static and dynamic data related to occlusion. The digital devices used (IOS, EOS, CBCT, and JTM) are commonly available, and the procedures of superimposing STL, OBJ,

The innovative aspect of the 4D virtual patient technique lies in incorporating clinical space-time information (the fourth dimension), transcending static models. The procedure can replicate the patient's occlusal scheme dynamically using digital clinical data.

There are more references available in the full text version of this article.

Copyright © 2024 by the Editorial Council of The Journal of Prosthetic Dentistry. All rights reserved.