Help me understand the Digital implant impressions process!

[drock]

Hi all,

I can't seem to find any accurate info on this. But can someone with REAL working experience and DEEP Knowledge of the world of digital implant impressions explain how this works?
Maybe more specifically with itero. From what I understand itero is only partnered with 3i and straumann correct? So that means I and the doctor will need to get the scan bodies from the respective company 3i or straumann which ever is being used. And I need to get their library? Do I have to get it from them? Or do other companies sell them too?
Now what if an itero Dr wants to scan an implant other than those two? What then? For expample for denstply Astra, I need to search for a 3rd party company that has a scan body for that platform and compatible with itero?? The Dr will need one as well as me? Is the IO scan body different than lab ones?
Universal scan bodies- what exactly does that mean? It will work with any IO scanner.
Does each scan body company have their own library?
If I use scan bodies from Straumann or 3i does that mean I have to use their mill facility or can I still mill in house? Or do I need to use the universal scan bodies? If different scan bodies are used other than straumann or 3i, does the Dr need to download something to use the different scan body.
Does each IOS partner up with implant companies? Is there an iOS that can scan any implant system?
Do I need to get Digital model analogs from the same place I got the scan bodies from? Please provide me with some accurate info rather than guesses Thank you all.

 

[dmonwaxa]

How does one determine what's accurate if one does not know? And if someone knows what's accurate, why would they need accurate instruction?........HMMM!!!!

 

[Tayebdental]

How does one determine what's accurate if one does not know? And if someone knows what's accurate, why would they need accurate instruction?........HMMM!!!!

but I am still confused

 

[CoolHandLuke]

Hi all,

I can't seem to find any accurate info on this. But can someone with REAL working experience and DEEP Knowledge of the world of digital implant impressions explain how this works?
Maybe more specifically with itero. From what I understand itero is only partnered with 3i and straumann correct? So that means I and the doctor will need to get the scan bodies from the respective company 3i or straumann which ever is being used. And I need to get their library? Do I have to get it from them? Or do other companies sell them too?
Now what if an itero Dr wants to scan an implant other than those two? What then? For expample for denstply Astra, I need to search for a 3rd party company that has a scan body for that platform and compatible with itero?? The Dr will need one as well as me? Is the IO scan body different than lab ones?
Universal scan bodies- what exactly does that mean? It will work with any IO scanner.
Does each scan body company have their own library?
If I use scan bodies from Straumann or 3i does that mean I have to use their mill facility or can I still mill in house? Or do I need to use the universal scan bodies? If different scan bodies are used other than straumann or 3i, does the Dr need to download something to use the different scan body.
Does each IOS partner up with implant companies? Is there an iOS that can scan any implant system?
Do I need to get Digital model analogs from the same place I got the scan bodies from? Please provide me with some accurate info rather than guesses Thank you all.

theres a lot to unpack here.

as i understand it, no, iTero can be made to be open to all implant systems under certain conditions. those conditions being your iTero software needs to be updated with the library of the company you are working with. you then need to have full control of your files, as well as relinquishing full control of those files to the lab. so you need a top tier account with itero and so does the lab. then you get to decide what happens with the scan once it is taken, and the lab can use the scan to make models instead of having that done by itero in israel.

most implant scans for itero only amount to a single jaw scan and opposing anyway. this means that so long as the scan with the scan body matches the lab's library, your case can go ahead. if not, you will never get a proper alignment. this is why places like atlantis lock you into sending the file to them instead of letting you decide what to do.

so no, you will not be able to do anything in house if you are locked in any way whatsoever.

in regards to other IOS functionality, yes to a certain extent other IOS are able to just take a scan irrespective of the implant used and let the lab line up the scan body - much like the core3d operation. as long as the scan used the core3d scan flag, core3d will line up the data, and produce a model. because core3d makes scan bodies for both IOS and for stone models. so they make analogs. this means you can take a scan, have the case done with models, with few headaches.

companies like Nobel make that process harder by making their system proprietary.

when in doubt however, consult the lab you are using to determine what system they have already bought into, because its easier for the dentist to buy a batch of scan bodies than it is for a lab to completely retool because you wanted to go with a system they arent fully integrated into.

 

[eyeloveteeth]

there are many ways to do it, but not all paths line up the same and there are different hurdles along the way.

it is WAY too long of a post. if you want to shoot me a call, i'd be more than happy to explain

 

[drock]

Hey cool Hand, just to clarify I am the Lab. so as far as universal scan bodies? that means that it can be used for any implant company. And other than Core 3d what are the other 'open' options are there.

Thx eyes, certainly does seem like there's different paths, thats what makes this a bit confusing. i may give you a dingle.

 

[CoolHandLuke]

many options out there exist for the NT Trading shaped scanbodies. CAP uses them, Axsys, 3i, and others. thats a great start, but there may be better ones that suit you more.

just try to find a vendor that sells 3 things: scan bodies, a digital library, and a 3d printed model analog.

as an example: i only know Medentika to sell stone model analogs, which makes their system mostly useless for IOS purposes. this may have changed recently though, as we havent strayed from core3d in quite some time.

 

[CoolHandLuke]

just be aware that not all companies ti bases are created equal. when it comes to angling a screw channel or planning a bridge that needs non engaging... you will need to be invested in several systems in order to cater to all implant scenarios.

 

[CoolHandLuke]

the term Universal scan bodies is misleading. there isnt one so widely used as to be taken as universal. Nobel has the universal base however. but this means a ti base (not a scan body) that nobel will allow you to use to create hybrid abutments/src without needing to purchase the whole cs2 scanner in order to do. they will let you use any scanner. you still have to use nobel scan bodies though. how generous.

thats the only use of the term universal that i know off the top of my head.

 

[GoldRunner]

The Nobel "universal base" is not part of their IOS workflow. You can't "choose" it after selection IOS. It is only from a desktop scan with Elos scan bodies. They do plan to validate it for IOS and add it soon.

 

[Sevan P]

So you have all these companies that make scan bodies IO and desktop. OE companies like Nobel Biocare, Straumann, 3i, M.I.S., Implant Direct, Zimmer Bio Horizon and a few others. 3rd party companies like Tru Abutment, Glidewell, Dess, NT Trading, ELOS etc. Each have their own personal library designed to work with their scan bodies and their scan bodies only. Unless you tweak and crate your own library (hybrid) you must use its dedicated library. Certain companies have IO scan bodes like Nobel (Elos), they have a separate library for IO scan bodies, it is the same as the desktop library but the only thing different is the scan body within the library. You must select the IO library when setting up the trios, itero or any other IO scan order in 3shape.

Not all libraries are able to print implant models. Nobel, Dess, NT Trading, Straumann and soon M.I.S. all have DIM (Digital Implant Model) analog, which is different then the tradition implant replica used for stone casts. But all are ready for custom Ti abutment that have to be sent to the needed milling center to be produced, Nobel library designs go to Nobel, Straumann to Straumann and so on. You can not design on NT trading and have MIS or Implant direct mill it for you.

NOW, the hybrid Zr abutment you simply need to order the right part from the library's mfg, like Argen use the NT Trading library so they sell NT trading Ti bases and DIM analogs and print the implant models as well. MIS sells their own Ti bases and same with Glidewell. You can NOT use Glidewells Ti base on a abutment designed in Implant direct or Straumanns library.

All these companies will make other platforms as well. Nobel has a third party library that uses the same style IO and desktop marks (Elos) as for their platforms and they sell the needed ti bases. Keep in mind not all companies have non engaging ti bases and very few companies allow bars to be made with their libraries. Specially in house milling of Ti abutments just got harder Cause no one can sell you a ti blank to mill unless the lab is now 510K cleared or else the seller gets in trouble now.

I personally have scan markers from the following:
Glidewell
Implant Direct
MIS
Tru Abutment
NT Trading
Nobel Biocare
Straumann
Atlantis
Bio Horizon
3i

My little scan body storage kit.


3Shape has introduce a universal marker kit and so far a lot of big names are on board, this would make it so you buy one kit and all the libraries use the same scan bodies but still you send to Nobel or Straumann for manufacturing of the abutments, or in house and use the correct ti bases. But this will most likely be a while till complete and ready to roll out.

PM me and i will give you my cell call and i can explain even in depth how it all works.

Sorry for the longest post ever............................................

 

[sndmn2]

Very informative thread. Especially for a digital newbie such as myself. If I could hijack a question in here. Dr is sending an impression for a 4 unit bridge on Implant Direct Legacy. He's also sending the analogs along with it. I assume I can use either my NT Trading Zimmer scan bodies ( milled through Argen ) or genuine Zimmer scan bodies ,through 3I/ Zimmer , ( milled through 3i ) for a custom abutment.. However if I chose to mill through Implant Direct I would also need their scan bodies ? M.I.S. ? And in this scenario its really just preference as to who mills it ? thanks

 

[Car 54]

So you have all these companies that make scan bodies IO and desktop. OE companies like Nobel Biocare, Straumann, 3i, M.I.S., Implant Direct, Zimmer Bio Horizon and a few others. 3rd party companies like Tru Abutment, Glidewell, Dess, NT Trading, ELOS etc. Each have t
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PM me and i will give you my cell call and i can explain even in depth how it all works.

Sorry for the longest post ever............................................

Helpful, informative and friendly......keep posting Sevan, even if you think they're a bit long

 

[dmonwaxa]

I'm still not sure if this is accurate enough for the OP's question. Now Tyeb is even more confused... Thanks Sevan....

 

[Sevan P]

Today you is was Complex but easy! [emoji28]

Sent from my SM-G920V using Tapatalk

 

[dmonwaxa]

...

 

[Car 54]

*

 

[dmonwaxa]

Seriously though, this is excellent info being shared. There are many ways to skin this cat, as have been posted by CHL and Sevan P.
The Universal marker kit sounds nice but it sounds like there are gonna be built in controls within the SW to prevent export. No? This can mean pretty soon only those companies whose implant connection geometry along with the scan bodies thats in the library will be the ones to mill and provide parts ....strictly OEM.
And $$$

 

[dmonwaxa]

Going back to the OPs question, if I'm understanding correctly.

1.Can a restoration be made just from the scan data only providing the lab has the IOS library to work with making it model less.

2. If the lab decides to have a DIM, does it require the lab to have the IOS scan bodies or lab (benchtop) scanbodies?

Either way neither makes any sense because the scan info is already provided. This redundancy is unnecessary, and next to impossible
to achieve.

Now, tackling #1 since that's the only relevant issue here.

Can a model less design be accomplished? If not, What are the steps involved in preparing the scan for submission for DIM
processing.

Once the model is received, are there any further steps to the model that may need addressing?

Absent of any issues with the DIM is it then scanned in with the lab (benchtop) scanbodies and case is designed... is that correct?

 

[CoolHandLuke]

Going back to the OPs question, if I'm understanding correctly.

1.Can a restoration be made just from the scan data only providing the lab has the IOS library to work with making it model less.

2. If the lab decides to have a DIM, does it require the lab to have the IOS scan bodies or lab (benchtop) scanbodies?

Either way neither makes any sense because the scan info is already provided. This redundancy is unnecessary, and next to impossible
to achieve.

Now, tackling #1 since that's the only relevant issue here.

Can a model less design be accomplished? If not, What are the steps involved in preparing the scan for submission for DIM
processing.

Once the model is received, are there any further steps to the model that may need addressing?

Absent of any issues with the DIM is it then scanned in with the lab (benchtop) scanbodies and case is designed... is that correct?

1. if you are going model free for a single implant or something, yes its entirely workable.

2. you will be required to have the identical scan body as used in the scan. thats all. whether the scan used Medentica or Elos, you have to be able to use the same scanbody. from that point your workflow is determined by what other things that company provides - if the company making Elos scan bodies only makes stone model analogs and not DIM analogs, you will need to fanagle the scan into a full model, duplicate it in vulcanizing rubber, snap the scan body to the stone model analog and pour it in stone to make your implant model. *IF* you even need it. alternatively run the scan through appliance designer, and 3dprint an appliance to use as a rough impression guide.

important to note when going model-free, your Ti bases may need alignment help, just refer to your design in order to replicate the on screen results. this is why ti bases with only one lobe for determining rotation is desireable. the universal base contains symmetrical geometry top half, so you can be pi rads out.

i dont understand your last question. can you please reconstruct your thought process?