Sydney Dental Specialists

14/08/2023

26/07/2021

The Scan-Guide (Full protocol : every gambit, flimflam and stratagem)

Immediate loading a provisional full-arch implant supported prostheses may be a daunting prospect. The surgical field makes it difficult to locate a pre-made temporary prosthesis (especially if there is a ton of alveolar reduction involved) and impressions are often difficult to cross-mount with the planned waxup due to lack of adequate references. We could opt for a digital workflow that is cleaner with an intra-oral or extra oral scanner but getting an accurate repositioning of the waxup and performing a precise intraoral scan are often challenging.

There are some great workflows out there to get on top of these issues. I use a bone-anchored intra-oral scan guide to make it simpler.

The patient is an edentulous 70 plus vet who has opted for a fixed maxillary bridge and a 3-implant mandibular overdenture, with a plan of possibly replacing the lower overdenture with a fixed bridge by placing additional implants in the future.

The basic idea of this workflow is quite simple. Print a bone anchored copy of the scan appliance (Im calling it a Scan guide) , Use an IOS to scan it outside the mouth in occlusion and remove the teeth on the guide digitally and manually on the guide as well; then stitch the scanbody positions into this scan after implants and abutments are placed.

Are IOS sufficiently accurate to do full-arch impressions just by themselves ? The answer is complicated but its probably a tentative no at this stage according to the available evidence. The scan guide helps us to stitch the scan to a fixed landmark and we use a verification jig made from the 3D model to manually confirm the implant positions intraorally prior to prosthesis delivery (and potentially alter them if required)

More details under the photo descriptions

Obviously this approach works a lot better when the surgery is completely guided

Surgery by Dr. Jasvir Singh
Technical Work by Nicola Redase


www.siddhantaprosthodontics.com

15/02/2019

Stunning aesthetics by the team. Management of tooth discolouration from tetracycline related staining. Porcelain veneers placed on the upper front teeth by Dr Stephen Travis.

22/10/2018

Really nice natural match of a single tooth crown. Patient was very happy with the outcome

10/09/2018

Beautiful single tooth implant replacing a lateral incisor tooth.

Surgery by David Leinkram, Prosthodontics by Stephen Travis and Ceramics by Nic Redase.

29/08/2018

Dominik, thank you for your artistic drawing of Dr Stephen Travis.

Safe travels back home and thank you for all your help in our dental lab. You will be greatly missed by the team

13/07/2018

Some beautiful work by Prosthodontist Prashant Patel, Orthodontist Gregory Forsyth and Ceramist Nic Redase.

An interdisciplinary treatment plan was required with a combination of orthodontic therapy and ceramic restorations to create a natural smile.

23/05/2018

Happy patient = happy staff. Stay tuned for the final treatment outcome