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Digital Implant Scan Workflow

Course outline: Introduction to digital dentistry The use of intraoral scanners to take accurate implant scans Design perfect-fitting restorations using exoCAD software Carry out the digital workflow from scan to design Attendees: Dental Specialists General dental practitioners Recently gradate dental students and interns Dental technicians Course input: Student should be familiar with Undergraduate level prosthodontics Undergraduate level implant dentistry Basic computer skills Objectives: By the end of this workshop attendees should be able to use intra-oral scanner to: 1- Plan implant cases using digital diagnostic scans 2- Perform implant scans for single unit, partial edentulous and fully edentulous arches 3- Workout the implant scans to execute provisional or final restorations Course output: Knowledge 1- Understand the difference between conventional and digital implant workflow for the fabrication of implant-supported restorations. 2- Understand the pros and cons of conventional and digital workflows for the fabrication of implant-supported restorations. 3- Understand the electronic files transfer from device to device in order to fabricate implant-supported restorations 4- Understand “open” or “closed” milling systems in order to accept and transfer electronic files from devices of different manufacturers. 5- Understand the steps of dynamic digital workflow which combine conventional and digital workflows for the design of implant-supported restorations. 6- Understand the steps of complete digital workflow for the fabrication of implant- supported restorations. 7- Perform self-assessment and appropriate adjustments to the digital workflows of implant-supported restorations. Skills 1- Apply digital technologies to assessment, diagnosis, and treatment planning. 2- Identify indications and limitations of digitally designed and fabricated implant-supported restorations. 3- Select the appropriate digital workflow for the fabrication of implant-supported restorations. 4- Assess, diagnose, treatment plan, and deliver digitally scanned and designed single-unit and partially edentulous implant-supported restorations. 5- Perform intraoral scanning for implant-supported single unit, and partial and fully edentulous restorations. 6- Transfer digital files from device to device as STL files. 7- Evaluate digital models and proposed digital designs for single-unit restorations. Digital Implant Scan Workflow Agenda: 8:30 am - 10:20 am · Introduction to implant scan workflow · Implant scan for single unit Coffee break 10:30 am - 12:20 pm · Implant scan for partial edentulous · Implant scan for fully edentulous arches Lunch and prayer 01:00 pm - 3:30 pm · Using ExoCAD software to design implant-supported restoration Digital Implant Scan Workflow Implant scan for single unit 1- Model scan a. Scan the mandibular arch b. Scan the maxillary arch c. Maxillo-mandibular interocclusal registration 2- Gingival scan a. Soft tissue recording and locking 3- Scan body scan a. Place the scan-body and check the fit radiographically b. take a scan over the locked soft tissue 📷 Implant scan for partial edentulous 1- Follow the same steps as mentioned previously but for two implants 2- Fabricate the verification jig chair-side 📷 References for Implant scan for partially edentulous arches 1. Alsharbaty, M.H.M., et al., A Clinical Comparative Study of 3-Dimensional Accuracy between Digital and Conventional Implant Impression Techniques. J Prosthodont, 2019. 28(4): p. e902-e908. 2. Joda, T., F. Zarone, and M. Ferrari, The complete digital workflow in fixed prosthodontics: a systematic review. BMC Oral Health, 2017. 17(1): p. 124. 3. Michelinakis, G., et al., The direct digital workflow in fixed implant prosthodontics: a narrative review. BMC Oral Health, 2021. 21(1): p. 37. 4. Tallarico, M., et al., Accuracy of computer-assisted template-based implant placement using conventional impression and scan model or intraoral digital impression: A randomised controlled trial with 1 year of follow-up. Int J Oral Implantol (Berl), 2019. 12(2): p. 197-206. Implant scan for fully edentulous arches 📷 📷 References for Implant scan for fully edentulous arches 1. Ahmed, W.M., T.V. Verhaeghe, and A.P.G. McCullagh, Maxillary complete-arch implant-supported restoration: A digital scanning and maxillomandibular relationship workflow. J Prosthet Dent, 2020.Lo Russo L, Caradonna G, Troiano G, Salamini A, Guida L, Ciavarella D. Three-dimensional differences between intraoral scans and conventional impressions of edentulous jaws: A clinical study. J Prosthet Dent. 2019. 2. Fang J, An X, Jeong S, Choi B. Development of complete dentures based on digital intraoral impressions-Case report. J Prosthodont Res 2018;62:116-20. 3. Kim J, Amelya A, Shin Y, Shim J. Accuracy of intraoral digital impressions using an artificial landmark. J Prosthet Dent 2017;117:755-61. 4. Papaspyridakos P, Gallucci G, Chen C, Hanssen S, Naert I, Vandenberghe B. Digital versus conventional implant impressions for edentulous patients: Accuracy outcomes. Clin Oral Implants Res 2016;27:465-72. 5. Amin S, Weber H, Finkelman M, El Rafie K, Kudara Y, Papaspyridakos P. Digital vs. conventional full-arch implant impressions: A comparative study. Clin Oral Implants Res 2017;28:1360-7. 6. Vandeweghe S, Vervack V, Dierens M, De Bruyn H. Accuracy of digital impressions of multiple dental implants: An in vitro study. Clin Oral Implants Res 2017;28:648-53. 7. Di Fiore A, Meneghello R, Graiff L, Savio G, Vigolo P, Monaco C, et al. Full arch digital scanning systems performances for implant-supported fixed dental prostheses: A comparative study of 8 intraoral scanners. J Prosthodont Res 2019;63(4):396-403. 8. Pesce P, Pera F, Setti P, Menini M. Precision and accuracy of a digital impression scanner in full-arch implant rehabilitation. Int J Prosthodont 2018;31:171-5. 9. Gimenez-Gonzalez B, Hassan B, Özcan M, Pradies G. An in vitro study of factors influencing the performance of digital intraoral impressions operating on active wavefront sampling technology with multiple implants in the edentulous maxilla. J Prosthodont 2017;26:650-5. 10. Michelinakis G, Nikolidakis D. Using the surgical guide for impression-free digital bite registration in the edentulous maxilla – a technical note. Int J Imp Dent 2019. 2019;5:19. 11. An X, Fang J, Jeong S, Choi B. A CAD-CAM technique for conversion of interim-to-definitive restoration in patients with complete edentulism. J Prosthet Dent 2018;120:190-3. 12. Iturrate M, Minguez R, Pradies G, Solaberrieta E. Obtaining reliable intraoral digital scans for an implant-supported complete-arch prosthesis: A dental technique. J Prosthet Dent 2019;121:237-41. Using ExoCAD software to design implant-supported restoration 📷 Step 1 : Select the option Switch Implant Connection Library 📷 Step 2: Choose one of the compatible library options from the drop-down menu 📷 Step 3: In some implant connections you can also change the diameter as seen below 📷 Step 3: Select Implant Type In order to change the implant reconstruction type, for example, from custom abutment to screw retained, please enter in the expert mode and select the option Select Implant Type 📷 In the drop-down menu, you can now choose a different option 📷 Click OK to apply the changes. Next: Matching the scan abutments https://www.youtube.com/embed/9AVi2lhAxZI?start=216&autoplay=1&cc_load_policy=1 Next: Editing Emergence Profile https://www.youtube.com/embed/9AVi2lhAxZI?start=412&autoplay=1&cc_load_policy=1 Next: Tooth model placement https://www.youtube.com/embed/9AVi2lhAxZI?start=649&autoplay=1&cc_load_policy=1 Next: Generate abutment bottoms https://www.youtube.com/embed/9AVi2lhAxZI?start=753&autoplay=1&cc_load_policy=1 Next: Designing the full anatomy; designing framework (for screw retained structures) https://wiki.exocad.com/wiki/index.php/Designing_the_full_anatomy;_designing_framework_(for_screw_retained_structures) Next: Editing Screw hole design https://www.youtube.com/embed/9AVi2lhAxZI?start=1974&autoplay=1&cc_load_policy=1 Next: Define insertion axis https://www.youtube.com/embed/9AVi2lhAxZI?start=1262&autoplay=1&cc_load_policy=1 Next: Abutment design https://www.youtube.com/embed/9AVi2lhAxZI?start=1350&autoplay=1&cc_load_policy=1