Can you design with your cbct scans?

M

MTDentalTech

New Member
Full Member
Hello, I had a doctor approach me and ask if you can design a ti bar when you only receive the models before implant placement and cbct scans. I am curious if i scan in the models and have the scans with the implants placed where he "wants" to put them if i could use that in a way to design a ti bar. I know that the implants will not be exactly where he is planning due the complexity of implant placement, but I am wondering if i could use that to design a ti bar then section it and have him weld in the mouth the connections to it. Yes he does intra oral welding and thats why he posed this to me. If anyone has suggestions on this please i would greatly appreciate it or just have a discussion about how it might be done. I have full 3shape and Zirkonzahn (exocad) software so i can flip flop at any stage or anyone with experience in each has an idea to only do it in one then all the better. This has turned into a fun experimental thing for our lab to see if we can do. Thanks in advance!
 
CoolHandLuke

CoolHandLuke

40% titanium
Staff member
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depends on the quality of the cbct scan.

its a very bad idea, but it is possible. maybe a better idea would be to create a bar out of flexible or non metallic material to flex as the implants integrate, then redo the prosthetic design after 6 months when the implants are healed.
 
M

MTDentalTech

New Member
Full Member
We do tons of AO4 and that was the first thing i said to him when he brought the idea to me, but what i am wanting to do is design a bar basically then cut it and let him screw it in the mouth then weld the difference in. He currently welds an entire bar from scratch in the mouth, so he is looking for an easier way of doing it at time of surgery. Also he temporizing an acrylic denture over it at time of delivery. And wants us to mill a pmma to go over this "bar" then window it out and he relines the bar in in the mouth. this way it can be a longer term temp or even depending on the situation a "definitive restoration". I still think the traditional work flow is better but this could open the door to a definitive all on four restorations at time of surgery, that can hold up and be safe for the patient.


depends on the quality of the cbct scan.

its a very bad idea, but it is possible. maybe a better idea would be to create a bar out of flexible or non metallic material to flex as the implants integrate, then redo the prosthetic design after 6 months when the implants are healed.
 
JMN

JMN

Christian Member
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Donator
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We do tons of AO4 and that was the first thing i said to him when he brought the idea to me, but what i am wanting to do is design a bar basically then cut it and let him screw it in the mouth then weld the difference in. He currently welds an entire bar from scratch in the mouth, so he is looking for an easier way of doing it at time of surgery. Also he temporizing an acrylic denture over it at time of delivery. And wants us to mill a pmma to go over this "bar" then window it out and he relines the bar in in the mouth. this way it can be a longer term temp or even depending on the situation a "definitive restoration". I still think the traditional work flow is better but this could open the door to a definitive all on four restorations at time of surgery, that can hold up and be safe for the patient.
If he's dead set on this course, tell him to hold a mouthful of barium sulfate for as long as it takes to get a good scan. If he is willing to put patients through that, then it will give a much better contrast between soft tissue and air. So long as the patient doesn't spew everywhere first. It's nasty.
 
2thm8kr

2thm8kr

Beanosavedmysociallife
Full Member
Any radio opaque material or patient motion during the scan causes artifacts or scatter. So do fiduciary markers added to scan appliances. Optical scans of the soft tissue either from IOS or impressions and desk top scans introduce inaccuracies. Couple that with inaccuracies of matching the data set to optical scans and don't forget that the different surgucal guides add an unknown of .5mm in any direction....

How far off are we from the planned positon now?

If memory serves me, we need 2 micron accuracy for a passive fit of screw retained bars.32458


Probably not the best approach, but techniques have to start somewhere.

I can tell you from making temps before surgery with holes cut for temp cylinders that most time serious adjustments are needed because of deviations in the planned positon and where the implants end up in reality. That could be some thick joints to spot weld together.

I'd nist certainly be interested to hear so experiences from trying.
 
Reactions: JMN
M

MTDentalTech

New Member
Full Member
Thanks for your inputs i have been told from above that i am doing it, so i will let you all know how this is going to go. Ill let you know how i do it too, i have a few ideas but it will be interesting to see which one i am allowed to do.
 
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