Sitting in airport so I figured I’d share…Here is a really cool (I think so!) case I just started last week. Patient was wearing rpd to replace 7-10 as well as max posteriors. We prepped 5,6, 11,12,13 and planscanned full upper preop and prepped arch, lower, and buccal bite. Sent stl files via ddx (digital dental exchange preloaded on your laptop with romexis) to Hennessey lab in West Palm Beach. They imported .stl files into 3 shape software, 3d printed models, digitally designing cutback zi framework 5-13 with 5 and 13 cloned to retrofit rpd. Cut anteriors off rpd. Some of scans of work in progress below. We are set to try in zi frame with rpd next week or so, then will have veneered ceramic added to finish case. No impressions at all! Images are combo of planscan and 3 shape. Will update with full photos as case finishes (assuming it works!…or will show where we failed!).I failed to delete pt info but pt ok and pre signed waiver for potential presentation purposes.
Very cool! How did you stabilize the bite relation to get the BB scans?
Thank you for sharing this! Give us some sense for difficulty in getting to this point. Did you have trouble with the scans and if so, what did you do to overcome it?
the scan files look great in 3shape too, pretty advanced stuff!
Remarkably, I was surprised at how easy the scans were! Each ‘full arch’ scan took less than 1-2 minutes. It picked up the soft tissues wonderfully and just tracked right along and I flipped scanner after crossing incisal papilla and it just flowed. I utilized a white plastic mirror and an assistant with a plastic mirror for lip/cheek retraction. Regarding my bucal bite..I’m sure this can be criticized, but I marked vdo with nose-chin marks and measurement, then took a little squirt of bite reg and put it on abt teeth with rpd in place and had pt bite down. Her bite is actually somewhat occluding on metal lingual plate of rpd. I then took rpd out and remeasured vdo with her biting first on bite reg in place bilaterally, then with bite reg unilaterally. Once I established that she was biting in what appeared to be the same manner with rpd in/out and bite reg unilaterally in position, I scanned contralateral side without bite reg, stopped scan and switched out the registration and continued on. It was pretty easy…but obviously opens up room for error. We’ll see how it all comes together in next week or so!!
That’s a good trick, probably how I’d have done it too. And if things are off at frame try in you could redo the bite with the frame in and articulate the printed models. Great case, thanks for sharing it!
Exactly! Thats the plan…but it will be awesome if it just clicks in. Hope for best plan for worst!