Digital Implant Impression
Fig. 1
Digital impression taking of implants with an intraoral scanner (Fig.1) is now
possible with Cadent
iTero®,
Lava C.O.S./3MTrue Def and
Sirona CEREC
scanners. Scanner manufacturers cooperate with select implant manufacturers
to facilitate this process. The scan process is different from implant
system to implant system and scan system to scan system. Biomet 3i
utilizes the already existing Encode® healing abutment while
Straumann® utilizes special scanbodys for example.
Cadent iTero®
Biomet 3i
Fig. 2
Already installed Encode®
healing abutments (Fig.2) are simply scanned with
the Cadent iTero® intra oral scanner and the scan data is
transmitted to a participating dental laboratory. The laboratory then
forwards the scan file to Biomet 3i Bella Tek with attached
electronic work order
where the
abutment will be designed and milled. At the same time Biomet 3i
forwards a copy of the abutment design file to Cadent where a
physical model of the dentition and the designed abutment is milled out of
polyurethane. Both Biomet 3i and Cadent send the finished
abutment and milled models respectively to the laboratory originally
submitting the scan data. The Laboratory merges the outsourced production
streams in to a single patient case to produce the actual final restoration.
iTero®/Encode® digital workflow
Glidewell Laboratories Inc.
Fig. 3
Glidewell Laboratories Inc. offers proprietary scan pegs (Fig.3) through the
Inclusive® house brand. The healing abutment is removed from the
implant and the appropriate scan peg is installed (Fig.4) on to the implant.
Scanning commences once proper seating of the scan peg is verified. Choose
Glidewell from within the iTero® electronic Rx and send the file.
Fig. 4
Nine different implant/abutment interface designs may be serviced with the
complete Inclusive®
Scanning Abutment Kit. Individual scan pegs may also be purchased for Astra
Tech, Biomet 3i, Brånemark, Keystone PrimaConnex®, Neoss,
NobelActive, NobelReplace, Straumann® and Zimmer. Due to
the compatibility of the implant/abutment interface of some of the above
listed implant brands with other implant brands a wide array of implants
may be digitally impressed through Inclusive® scan abutments.
Straumann®
Fig. 5
Both, tissue level and bone level implants can be "impressed" with this
technique. Straumann®
utilizes three component scan pegs for the scan procedure. The three
components are a scan cylinder (Fig.5, A), fixation screw (Fig.5, B) and
scan cap (Fig.5, C). To prepare for the intraoral scan the healing abutment
is removed from the implant and the scan cylinder is installed on to the
implant, ensuring proper engagement and seating of the indexing feature
(quadrigon). Hand tighten the fixation screw and snap the scan cap
on to the cylinder. The scan cylinder is machined with two opposing inside
flat sides corresponding to two flat sides on the scan cap. Both flat sides
have to be aligned correctly while pressing the scan cap on to the scan
cylinder. After the
scanbody (Fig.5, D) is installed and completely
assembled, the scan may commence.
Fig. 6
The resulting scan file (Fig.6) is then electronically sent to a dental
laboratory that is part of the iTero®/Cadent network. Here the
file can simply be forwarded to Cadent where a model with a
symmetrical receptacle for special, reusable push in type analogs is milled.
Stock or custom abutments may then be produced on the Cadent model.
Laboratories with a CS2 scanner and software can at the same time the model
is milled at Cadent design a virtual custom abutment to be milled
exclusively through the Straumann® etkon central milling facility.
D4D, E4D
No major implant manufacturer has announced a partnership with D4D/E4D to
facilitate intraoral scanning of implants at this time.
3shape Trios®
The Trios® powder less intraoral scanner integrates seamlessly through
3shape's cloud based Communicate file
interchange service. Laboratories
with 3shape's popular laboratory scanning system on the premises may take full
advantage of the Trios® connectivity. No major implant manufacturer has
announced a partnership with 3shape to facilitate intraoral scanning of implants
at this time. Due to the open nature of 3shape® scanners dentists and
laboratories must develop their own digital work flow and manufacturing processes.
Lava Chair side Oral Scanner (C.O.S.)
Biomet 3i
Already installed Encode®
healing abutments are simply scanned with the Lava intra oral scanner
and the scan data is transmitted to Biomet 3i Bella Tek. There
a technician designs a virtual custom abutment within the 3D digital scan
model and forwards the complete design file to a designated dental laboratory
with 3M ESPE Lava C.O.S. software capabilities. The
laboratory reviews the abutment design, orders the abutment to be milled,
marks the margin of the abutment and creates virtual die cuts.
Now the design file work up is uploaded to 3M ESPE to create
a physical model through stereolithographic printing, including a copy of
the approved custom abutment. The dental laboratory may design and mill
the final restoration for the custom abutment through CAD-CAM technology
from the virtual design file or wait for the arrival of the physical model
to produce a restoration through conventional methods. Biomet 3i
Bella Tek ships the milled custom abutment to the dental laboratory
where it will be packaged with the stereolithography model and the final
restoration for delivery to the dental office.
Sirona CEREC
Biomet 3i®
Already installed Encode®
healing abutments, surrounding tissue and dentition are sprayed with a
antireflective medium (CEREC Optispray) and scanned with
the CEREC intra oral scanner. The scan data is transmitted through the
CEREC Connect
portal to Biomet 3i Bella Tek where a custom
abutment is designed and milled out of titanium or zirconia. Biomet 3i
sends the finished abutment directly to the submitting dentist and the
abutment is then installed on to the implant and rescanned to produce the
definitive restoration.
CEREC/Encode® digital workflow,
Biomet 3i® electronic work order
Straumann®
Fig. 7
Straumann® utilizes special scan pegs (Fig.7) for the scan process. Healing
abutments are removed from the implant in the patients mouth and implant
platform diameter specific scan pegs are installed on to the implant. The
scan procedure is initiated once the seating of the scan pegs is verified.
Only tissue level implants can be "impressed" with this
technique. The resulting scan file is then electronically sent to a
participating laboratory.
Image "Fig.1" courtesy of Dr. Osvaldo Z. Mayoral, DMD, Pinecrest Florida,
Pinecrest Dental.
Images "Fig.3" and "Fig.4" courtesy of Dr. Perry E. Jones D.D.S, FAGD,
Richmond Virginia, drperryjones.com
Images "Fig.5", "Fig.6" and "Fig.7" courtesy of
Straumann USA, LLC, its parents, affiliates or subsidiaries. © Straumann USA LLC, all rights reserved.