PREOP MARYLAND BRIDGE AND 3D PRINTING
Here is a technique that will save you time when provisionalizing implants.
Patient needs tooth #10 extracted and grafted. At the consult appt, I took a scan of just his upper teeth (has an anterior open bite)
I exported the .stl file and put a base/hollowed out with inLab 18 and 3D printed the model
Next, I went to the Omnicam and selected Bridge Mode (veneer #9 Biogeneric and pontic #10 Biocopy) and scanned the 3D printed model in as the Biocopy. Next, using a carbide bur, I went ahead and cut out tooth #10
We then fabricated a maryland bridge out of GC Cerasmart...
All ready for surgery next week!
I thought you could just use cut and fill tool to remove tooth in 4.5 ??
Why mill off 3d model to trim out tooth if you can do this in software?
It’s not as accurate to cut out tooth in software and i like to fit it ahead of time to minimize the work clinically.
because its messy to seat these and clean up the cement immediately after surgery, have u ever tried extending the wing onto the incisal edge to act as a seating jig and then cut back what you dont need , makes bonding so much easier with a positive seat instead of just the wing
I don’t have any issue and have done many.
You need to use Teflon tape. Covers perfectly surgical site
Mike agree on this workflow. SInce I have a cerec scan for the guide work up it is a process that really take minimal time. In addition to your comments on fitting I feel I do better sculpting Pontic sites when I do it the analog way with a handpiece on a model.
I will also use these models and do further model surgery when I use a digiguide to place and analog and premake the provisional and or Abutment prior to the implant surgery. Wish there was a easy digital way but am now very comfortable with the model surgery approach
I like the pre-made workflow but it's easier for me now to just do them on the day of surgery and I find them to be even more accurate that way:
1.) Pre-op scan, biocopy, cut out tooth
2.) Immediately after extraction: Quick 30 second scan of that area and merge with cut out model
3.) Hand off to assistant to make Maryland temp while I am doing grafting, implant, etc.
4.) Bond in
Here is one I did yesterday:
Farhad
