You may or may not have read some of my previous posts, but I have been volunteering at a clinic that serves the homeless and low income families and Vets called Brighterway. Been doing it for about 6 months and the goal was to try to figure out what was the best way to go model free when making hybrids, dentures and over dentures using high tech scanners like CEREC and 3shape. And although I would love to say “Just scan away and send to a lab.”, we found that that was not the case. If you have an Intra Oral Scanner (IOS) you many know how these images are acquired. Each small picture is overlapped and “stitched” to the last using common data. Which is easy with teeth, but gums and scan bodies are a whole other animal. These little pictures, after a while, lead to inaccuracy across the arch, resulting in stuff that doesn’t fit. Enter Photogrammetry, which I will discuss next. Surgery by Dr Joe Mehranfar at one of his classes on All on 4 at Brighterway Live
At the time of surgery, her dentures were converted and she wore these for a year. As with all converted dentures, over time they break. So we wanted to go with something stronger. The dominos or dice you see are scan bodies for a system called Imetric 4D. This system functions more like a lab scanner, with images taken extra orally and much less images total. Maybe 60 vs 500, with accuracy down to 10 microns. We get the bite and the soft tissue from the 3shape scan, then use the implant positions fro the Imetric Scan.
And now for the Nerfest!! A free app from the iPhone 10 and above called Bellus 3D takes really nice 3D face scans that the lab can relate to the model. Wow had a tough time and its hard to see in pics, but you can see in the video that this patient’s nose is deviated to the right. So we used the patient’s eyes to match up the midline. The Imetric scan was incorporated into ExoCAD and then Burbank Dental went to work!
We went with milled PMMA for these and will do Zirconia later. Could you go with Zirconia, straight to final? I am thinking you can! Our next few we will go straight to final, but this should hold up for another year or two! Great job by Burbank Dental Lab and surgery by Dr Joe Mehranfar. Check out the video, she seems happy :}
Here is the final, Burbank Dental lab did an amazing job! hard to believe that this patient lost most of her teeth in her 20s!
You can see how nice the bite was!
Patient was truly thrilled with the end result!
We are doing a CEREC Live Patient Implant Course in Phoenix where we will cover CEREC Guide 2, Scanning with Scan Posts for Abutments and Crowns, as well as demoing full arch scanning with Primescan and Digital Dentures! Feb 20-22 2020. If you are a Trios user we can adapt the hands on for you!
If you want to know how to make guides, aligners, digital dentures and more, come to a 3D Printing party!! Dec 13-14 in Minneapolis!!