Four-Dimensional (4D) Virtual Simulation for Predicting Soft Tissue Support and Vertical Dimension of Occlusion in Full-Arch Implant Therapy - A Proof of Concept.

Abstract

Objective: To describe a proof-of-concept digital workflow for four-dimensional (4D) virtual simulation of facial soft tissue support in edentulous patients, based on a real clinical case.

Methods: A non-invasive digital workflow was developed using intraoral, extraoral, and laboratory scans. These datasets were merged into a simulation three-dimensional (3D) model using finite element methods. Skeletal structures were represented by surface meshes, and soft tissues by volumetric tetrahedral elements. Simulations predicted changes in lip support, occlusal vertical dimension, and facial esthetics. The workflow required no additional radiographic imaging and utilized standard clinical scanning tools.

Results: The technique was demonstrated on a fully edentulous patient and proved clinically feasible. Accurate alignment of intraoral and facial scans enabled dynamic visualization of soft tissue changes, supporting both fixed and removable prosthetic scenarios. The patient could preview functional and esthetic outcomes before treatment initiation.

Conclusions: This approach improves treatment predictability, supports interdisciplinary collaboration, and reduces reliance on conventional methods. It enhances personalized prosthodontic planning, streamlines communication between clinician, technician, and patient, and shortens chairside time-aligning with the growing demand for patient-centered care.

Clinical significance: This proof-of-concept study demonstrates the feasibility of using 4D virtual simulation to visualize soft tissue changes in edentulous patients before treatment. The workflow offers a non-invasive, digital approach that may enhance communication, improve planning accuracy, and support clinical decision-making in full-arch prosthetic rehabilitation.