Course Objectives (2 CE Credits)
Implant cases rely heavily on accuracy and predictability, both of which can be greatly enhanced using the latest computer-aided techniques. In his written case report and accompanying video, Dr. Perry Jones utilizes an intraoral optical scanning system, followed by the CAD/CAM design and milling of all-zirconia custom abutments and a monolithic zirconia bridge, to restore a historically problematic anterior case. His presentation demonstrates the following concepts and technologies:
- Evaluating implant stability
- Inclusive® Scanning Abutments (Glidewell Laboratories)
- iTero™ Digital Scanning System (Align Technology, Inc.; Santa Clara, Calif.)
- CAD/CAM abutment design utilizing 3Shape DentalDesigner™ (3Shape A/S; Copenhagen, Denmark)
- CAD/CAM fabrication of monolithic BruxZir® Solid Zirconia anterior bridges (Glidewell Laboratories)
Digital technology continues to revolutionize the methods of modern dentistry, benefitting every phase of treatment from diagnosis to final restoration. As the long-term success of any implant faces threat from masticatory function, it is critical not only to ensure proper placement, but also to relieve or eliminate undue mechanical stresses that may result from a poorly planned restoration. Taking full advantage of the latest computer-aided techniques as demonstrated here can help to ensure the optimal design of, and precise fit between, the full chain of restorative components, thereby reducing the risk of failure.
CAUTION: When viewing the techniques, procedures, theories and materials that are presented, you must make your own decisions about specific treatment for patients and exercise personal professional judgment regarding the need for further clinical testing or education and your own clinical expertise before trying to implement new procedures.
- Baldissara P, Llukacej A, Ciocca L, Valandro FL, Scotti R. Translucency of zirconia copings made with different CAD/CAM systems. J Prosthet Dent. 2010 Jul;104(1):6-12.
- Birnbaum NS, Aaronson HB. Dental impressions using 3D digital scanners: virtual becomes reality. Compend Contin Educ Dent. 2008 Oct;29(8):494, 496, 498-505.
- Chang YB, Xia JJ, Gateno J, Xiong X, Zhou X, Wong ST. An automatic and robust algorithm of reestablishment of digital dental occlusion. IEEE Trans Med Imaging. 2010 Sep;29(9):1652-63.
- Christensen GJ. Will digital impressions eliminate the current problems with conventional impressions? J Am Dent Assoc. 2008 Jun;139(6):761-3.
- Drago C, Saldarriaga RL, Domagala D, Almasri R. Volumetric determination of the amount of misfit in CAD/CAM and cast implant frameworks: a multicenter laboratory study. Int J Oral Maxillofac Implants. 2010 Sep-Oct;25(5):920-9.
- Ender A, Mehl A. Full arch scans: conventional versus digital impressions – an in-vitro study. Int J Comput Dent. 2011;14(1):11-21.
- Fasbinder DJ. Digital dentistry: innovation for restorative treatment. Compend Contin Educ Dent. 2010;31(4):2-11.
- Garg AK. Cadent iTero's digital system for dental impressions: the end of trays and putty? Dent Implantol Update. 2008 Jan;19(1):1-4.
- Henderson S. Align Technology Completes Acquisition of Intra-Oral Scanning Leader Cadent. 2011 May 2 [cited 2011 Oct 17]. Available from: http://investor.aligntech.com/releasedetail.cfm?releaseid=573469.
- Jones PE. Cadent iTero digital impression case study: full-arch fixed provisional bridge. DC Dentalcompare. 2009 Jul 8.
- Jones PE. Cadent iTero optical scanning digital impressions for restorative and invisalign. Dental Product Shopper. 2011 Jun 28.
- Kurbad A. Impression-free production techniques. Int J Comput Dent. 2011;14(1):59-66.
- Priest G. Virtual-designed and computer-milled implant abutments. J Oral Maxillofac Surg. 2005 Sep;63(9 Suppl 2):22-32.
- Smith R. Creating well-fitting restorations with a digital impression system. Compend Contin Educ Dent. 2010 Oct;31(8):640-4.
- Touchstone A, Nieting T, Ulmer N. Digital transition: the collaboration between dentists and laboratory technicians on CAD/CAM restorations. J Am Dent Assoc. 2010;141 Suppl 2:15S-9S.
- Zweig A. Improving impressions: go digital! Dent Today. 2009 Nov;28(11):100, 102, 104.