by Doctor Henriette Lerner, HL-DENTCLINIC DR. STOM. MEDIC.
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The evolution of digital dentistry and the development of a digital workflow has concentrated on digital planning with the use of Cone Beam CT scanning as well as using digital restorative tools to combine DICOM (Digital Imaging Communication in Medicine) and .stl (stereolithography) files to virtually plan, place and restore implants before using this plan to treat patients. The resulting benefits are reduced chair time, high precision and predictable aesthetic results often with immediate fixed provisional restorations available at time of surgery and corresponding high levels of patient satisfaction.
Intra-oral scanning to create digital ‘virtual impressions’ is also becoming more prevalent with the information being stored in the .stl file format. This information can be utilised by appropriate CAD/CAM (computer-aided design and computer aided manufacturing) software to design and manufacture a dental restoration (either by milling or 3D printing).
One area that is sometimes overlooked is the use of digital technology in occlusal analysis and adjustment of the restored dental implant. The following case study examines the occlusal management of a conventionally placed implant.
The use of Cone Beam Computerised Tomography (CBCT) scanning is becoming more commonplace in today’s implant dentistry. These scans combined with increasingly sophisticated software technology has led to greater accuracy in digital planning and guided surgery and is gradually being adopted across general practice. Furthermore, the restorative planning can be digitised and combined with the CBCT data in appropriate planning software.
In conjunction with these technology advances, dental implant design has evolved to incorporate the latest concepts of biomechanical design, which include sophisticated thread profiling, platform switching and a Morse locking taper on the implant/abutment interface.
The following case details brings these advances in implants and digital technologies together.
There has been a considerable evolution in implant dentistry over recent years that has seen the design of dental implants adopt sophisticated thread profiles which leads to a better primary stability. Simultaneously these new geometries aid cortical bone maintenance through to platform-switching capabilities again designed to minimise bone loss. When combined with improved implant-prosthetic connections such as a Morse-locking conical connection it contributes to a good long-term prognosis and an aesthetic outcome.
Concurrent with this evolution in implant design have been substantial advances in digital technologies across the field of dentistry. These digital advances include Cone-beam CT scanning combined with appropriate 3D planning software, navigated surgery technology, 3D intra-oral scanning to create a ‘virtual impression’ and 3D printing technologies. These digital technologies can minimise the number of appointments found in a conventional treatment protocol as well as enabling greater accuracy and will be considered in this case study.
A 55 year old female patient was referred to our office for a full mouth rehabilitation. Upon clinical examination and a CBCT, we have decided to implant 4 EL C-Tech conical Morse tapered connection implants in the upper jaw for a bar retained over denture and due to financial considerations; was to perform extraction of all remaining lower teeth and immediate post extraction implantation of SD C-Tech mini dental implants. A full muco-periosteal flap was released, teeth were extracted, an alveotomy was performed to achieve an optimal bone platform for the SD mini dental implants and to obtain a bigger vertical dimension for the overdenture!
The new drill stop kit is made of a milled and anodized aluminum sliding top and a Tekapro (autoclave resistant resin) base. The drill stops are in the base and when the top is slid into the “open” position, one can insert the drill into the appropriate length opening and pick up the corresponding drill stop without having to hold or touch the stops with ones finger’s. When the top is slid into the closed position, the stops are held safely in the base.The kit is autoclavable.
The kit can be ordered in 2 versions:
STOPKIT00: empty of drill stops
STOPKIT01: complete with all drill stops
Has total heights of 20mm and ideal for prosthetic in areas with low clearance.
CODE Ref. CT-9025XS
Un moncone Scan a pezzo unico disponibile in PEEK e TITANIO. Presente nelle librerie 3shape ed Exocad.
CODE Ref. EL-6040P • EL-6040
Nuove basi prive di esagono per facilitarne il posizionamento su restaurazioni multiple. Disponibile in 3 altezze gengivali, presenti nelle librerie 3shape ed Exocad. Sono dotate di un incavo nella parte superiore per facilitare l’entrata della vite nelle posizioni angolate.
CODE Ref. EL-6041R • EL-6042R • EL-6043R
Nuove basi per protesi cementata, sono disponibili in 3 altezze gengivali, presenti nelle librerie 3shape ed Exocad.
CODE Ref EL-6041 • EL-6042 • EL-6043
These cover screws facilitate easy access to subcrestally set EL/BL implants where the bone can cover and prevent access to the standard flush cover screw.
CODE Ref BL-4305 • BL-4305/1 • BL-4305/2 • BL-4305/3
These new 25° angled abutments with the CEC shape are available in 4 different gingival heights.
CODE Ref EL-251 • EL-252 • EL-253 • EL-254
These new 15° angled abutments with the CEC shape are available in 4 different gingival heights.
CODE Ref EL-151 • EL-152 • EL-153 • EL-154
This new member of the EL family is based on the prosthetic connection of the ND family, and accordingly is compatible with all the ND components.
CODE Ref ND-3009 • ND-3011 • ND-3013
These plastic, castable cylinders fit onto the titanium bases BL-6046, BL-6045, EL-6049 and EL-6049/3. In the case of the BL-6045, there already included one cylinder.
In the case that one would like to redo a cylinder or needs spare cylinders, this item, packed in individually or in sets of 4 can solve the problem.
CODE Ref EL-CAST – EL-CAST/4