Posted April 18, 2019
If you have been seeing anything that I have posted over the last few weeks you may have picked up that I have been doing some volunteer days at a clinic located in a homeless shelter in Phoenix called Brighterway. Brighterway delivers dentistry to the homeless, low income Vets and the working poor. I have always wanted to give back and have been in my office doing something called Operation Smile, where I donate once a month some dentistry utilizing some of the high tech tools at my office.
Brighterway just received a ton of incredible donated tech. They got 5 Trios machines from 3Shape, a complete Amangirbach Ceramill Desktop Scanner, computer, and 5 axis mill, and a printer from Carbon!! These tech companies wanted to give back as well and Dr Joe Mehrnefar and Scott Lauer, the two being running the clinic, weren’t comfortable with digital dentistry. Enter me!!
Fitst I should stop and thank a few pioneers that taught me how to do this. Dr Jonathan Abeniem teaches a course called Digital Dentistry to the Max as part if his courses as Smile Syllabus. I highly recommend you take it there is one in June in Vegas here is the link https://smilesyllabus.com. Jonathan really pioneered the workflow and as you can see with little dots of Liquid Dam, came up with a way to increase the accuracy of the scans. I would also like to thank Dr Armen Mirzayan and Sameer Puri who came out with the “SArmen Jig: which use irregular patterns to stitch scans back in the days of old in CEREC.
http://www.Digitalenamel.tv
I have been a CEREC user for 15 years, which I thought was a plus, but was actually a liability when using 3 shape. When doing any hybrid, be it digital or not, you need to capture the arch with the scan bodies or impression copies, but you have to also maintain the bite or VDO. In 3shape its kinda backwards. First you start with a pre preparation scan where you scan the hybrid I the mouth and get your buccal bites using these markers and “squiggles” of liquid dam to not only help stitch between the scan body scan and the pre op, but Trios tends to get lost a bit more than CEREC on soft tissue. Remove the old converted dentures and place scan bodies.
One nice thing that Trios does automatically is that if you scan the hybrid before, it starts “erasing” the old temp hybrid as you scan the scan bodies using the fiducial markers that Jonathan teaches. As you can see the bite was maintained. We are currently trying ways of doing this with overdentures. These are DESS scan bodies.
This was definitely a team effort!! There is an amazing 3shape (he can take any STL) designer from Minsk named Jacob Farber. His designs are truly the best I have ever seen!! He designed this within a day!! Contact him on Facebook on his page, ScanCAD3D. If you have been on social media you may know an amazing Lab Technician Arian Deutsch. Arian layered Anaxgum composite on these hybrids that were printed on the Asiga Max printer using NextDent MFH.
Delivery went perfect!! No adjustments, and I mean none!! The patient will wear these as “transitional” hybrids. The goal is to make sure the vertical is good, that the patient is happy with the esthetics and phonetics of the case and there is no food impaction. Once the patient is happy we will go to final!!
Here is the delivery video, no hand
pieces touched this after the composite gingiva was layered!!
If you want to learn all the cool techniques featured come to our very first Live Patient digital dentistry course, Digital Dentistry Live:” Level 1. Over 3 days you will get to design surgical guides, restorations, 3D print and mill!! We spend a full day in the clinic helping the homeless, the vets and the working poor get high end digital dentistry and implants! Anyone with a valid US license can get a license to treat patients at Brighterway!! Now you can get live hands on training without leaving the US! 21 hours CE. Register below!!
https://mailchi.mp/brighterwaydental/dentalimplantologylivelevel1
