Implant planning for partially endentulous patient with Trios

Jaemin Lee

Jaemin Lee

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Hello.

I'm going to show you how Implant Studio works with Trios.

For the accracy, the integration between CT image and Oral Surface image is critical.
And for the proper integration, you need some natural teeth which can be used as standards for merging.
However for edentulous patients you have to use a radiopaque material to merge oral surface image with CT image.

In that case, without Trios, you should make a cast model of patient and then you need a recording base which contains 'marker' for the integration.
With that recording base with marker, you can take a CT shot for the implant surgery planning.

However if you have Trios, you can easily attach the 'marker' on the gingiva with composite resin.
After that, you can just scan the patient's oral surface as markers attched, and then take a CT image
That is all you should do before planning the implant surgery.

It becomes shorter, easier and more precise with Trios.

Here is an example of implant planning with Implant Studio and Trios.
Note that the result is not a fianl one, I just only wanted to show the work flow of IS with Trios.

View media item 54
Order page

View media item 53
Trios scan with markers on the gingiva.

With those markers you can integrate CT image and oral scan images easily.

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Cropping CT

You don't need the image of other area which are not related to surgery

View media item 51
Scan Alignment

You can merge the oral scan image with CT image by pointing three different spots.
With the markers you can easily integrate images.

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Panoramic Curve

View media item 48
Nerve definition

It's easy to draw the nerve line.

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Designing provisionals

You can design the shape and position of the provisionals.

View media item 46
Implant planning

Now you can place the implants, there can be more implants which are supported by 3Shape.

View media item 45
You can check the safety zone around the projected drilling site, and you can easily reposition the implants by dragging or rotating it.


After the planning has ended, you can send the plan to the lab so that they can make the guide and provisionals.

Usually I only send implant planning order to the 3 Shape based lab with Trios Scan image and CT image.
Regarding implant surgery planning, they are faster and experienced than I am.
Only thing I have to do is just doublechecking the plan by reading the report from the lab.

But if you are interested, you can do it by yourself.
Even though you did it by yourself, still you need to discuss the plan with the experts in the lab.

I hope someone got help from this thread.
 
rkm rdt

rkm rdt

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Yes , I did.I can see you like Trios after all.;)

Would you be willing to post this on the Trios Study Club page on Facebook?
 
Jaemin Lee

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Yes , I did.I can see you like Trios after all.;)

Would you be willing to post this on the Trios Study Club page on Facebook?
Of course!
But I don't do facebook that much, would you please put a link here?
Then maybe I can get there easily..

And regarding Trios, yes I really love it.
I've already ordered 3rd version for an upgrade and it will be shipped next month.

When I first got Trios, I thought I could do everything modeless.
but things were not that easy.
Now I established my lab in the clinic, so maybe I can do better than before.

Next week, d2000, dwx 50 and mighm vight furnace will arrive.
And I am really really excited that I'll be able to do things with Trios more than before!!

Anyway thank you for accepting me as Trios lover! :)
 
rkm rdt

rkm rdt

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Of course!
But I don't do facebook that much, would you please put a link here?
Then maybe I can get there easily..

And regarding Trios, yes I really love it.
I've already ordered 3rd version for an upgrade and it will be shipped next month.

When I first got Trios, I thought I could do everything modeless.
but things were not that easy.
Now I established my lab in the clinic, so maybe I can do better than before.

Next week, d2000, dwx 50 and mighm vight furnace will arrive.
And I am really really excited that I'll be able to do things with Trios more than before!!

Anyway thank you for accepting me as Trios lover! :)

I thought at first you didn't like Trios but I was mistaken and apologize for being defensive. I now realize you are not a fan of going modeless and I have the same reservations about that.
Digital models could be better but its the best we have right now.

Here is the link and I hope you appreciate what I have created.

https://www.facebook.com/groups/1564020223839756/?fref=nf
 
BobCDT

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To me, this thread is really about Implant Studio (IS) rather than Trios. Yes, you can obtain the surface scan with a Trios but the planning is all about IS software from 3Shape. You can get the surface scan from a desk top or many IOS devices. The process includes merging the surface with a CDCT CNCT scan and merging the two into IS.
We have done a bunch of cases and the surgeons we have worked with have been very exited about guided surger and Implant Studio. I'll, post a case or two next week.
The software is very intuitive. If you know 3Shape, the learning cave is considerably less than what you would think. We have been printing the guides and I'm looking to mill a few in the new Roland and the AG Motion 2 mills. I'm not expecting any problems milling guides unless they include the horizontal pins for the fully edentureless cases. Overall, I believe this technology is a way to fast track a labs growth potential. First with more implant work then with more conventional stuff.
 
Jaemin Lee

Jaemin Lee

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I thought at first you didn't like Trios but I was mistaken and apologize for being defensive. I now realize you are not a fan of going modeless and I have the same reservations about that.
Digital models could be better but its the best we have right now.

Here is the link and I hope you appreciate what I have created.

https://www.facebook.com/groups/1564020223839756/?fref=nf

hello rkm, thank you for the invitation.
I had found your club by searching before you got me through to there with the link, and I asked to join already but now I cannot even see the club page, there is an error message up when I try to get your club.
Maybe I was rejected because you wouldnt know the account is mine. If not, I think I should ask for a help from facebook I guess.
Would you mind if I ask you to check my name on the request to join?
 
Jaemin Lee

Jaemin Lee

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To me, this thread is really about Implant Studio (IS) rather than Trios. Yes, you can obtain the surface scan with a Trios but the planning is all about IS software from 3Shape. You can get the surface scan from a desk top or many IOS devices. The process includes merging the surface with a CDCT CNCT scan and merging the two into IS.
We have done a bunch of cases and the surgeons we have worked with have been very exited about guided surger and Implant Studio. I'll, post a case or two next week.
The software is very intuitive. If you know 3Shape, the learning cave is considerably less than what you would think. We have been printing the guides and I'm looking to mill a few in the new Roland and the AG Motion 2 mills. I'm not expecting any problems milling guides unless they include the horizontal pins for the fully edentureless cases. Overall, I believe this technology is a way to fast track a labs growth potential. First with more implant work then with more conventional stuff.
Yes this is mostly about IS.
And the reason why I posted this thread in the name of Trios is the marker attached on the gingiva.
It might looks nothing and with recording base that would be made by labs you can still prepare for the IS supported surgery.
But with those markers and Trios, time can be saved much and also the accuracy increases.
Oral scan with Trios is more precise than model scanned data because there isn't any error that might happen while pouring stone or getting the impression. And the recordingbases can also make errors while getting CT images due to the mobility in the mouth.
And by the research from the dental college here, when you get the full arch scan, Cerec and iTero tend to make huge error compared with Trios. Regarding Cerec, when it comes to small area it was very accurate however as the scan goes curved area of canines the error beomes severe. But Trios, the error was about 0.05mm.
I think, until now, IS and direct oral scan by Trios is best match for the guided surgery. And in my opinion, if the gudie surgery does not go with immediate loading, it's nothing. For the experienced surgeons, if they want to do only implant surgery, the guide can be only waste of time and money. But even the surgeon is quite an expert at surgery, if he wants to do immediate loading, it takes lots of effort to make provisionals right after the surgery.
I think IS guided surgery system is the best answer for the immediate loading.
 
BobCDT

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with those markers and Trios, time can be saved much and also the accuracy increases.
Oral scan with Trios is more precise than model scanned data because there isn't any error
Can you please go into a little more detail about the marker. Was this part of an appliance made for the CAT scan and then used again for the Trios scan. I totally buy into the improved accuracy, especially in this case where the tooth alignment was really 2D without the markers. Was it fabricated with a plastic shell? Do you have a photo of the marker appliance?
Thanks,
 
cadfan

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If i am not wrong the markers are the two " normal scanmarkers" posterior left and right i think srcew retainend but you have to make ct and ios at the same time and take care with the markers ???!!!
 
Jaemin Lee

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Can you please go into a little more detail about the marker. Was this part of an appliance made for the CAT scan and then used again for the Trios scan. I totally buy into the improved accuracy, especially in this case where the tooth alignment was really 2D without the markers. Was it fabricated with a plastic shell? Do you have a photo of the marker appliance?
Thanks,
If i am not wrong the markers are the two " normal scanmarkers" posterior left and right i think srcew retainend but you have to make ct and ios at the same time and take care with the markers ???!!!
They are not screw retained. The markers are attached only by composite resin. And yes, you should be careful while ios and ct taking. But the attachment is stronger than u thought.
 
Jaemin Lee

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Can you please go into a little more detail about the marker. Was this part of an appliance made for the CAT scan and then used again for the Trios scan. I totally buy into the improved accuracy, especially in this case where the tooth alignment was really 2D without the markers. Was it fabricated with a plastic shell? Do you have a photo of the marker appliance?
Thanks,
As you've mentioned, the markers dont look like that much special. For me, they only look like just plastic buttons with radiopacity.
But as I am not a developer, I do not know much about the details around the markers. So I'll give you an email of developer. [email protected]
His name is Dong-wook Jung.
He works for Dio implant and he is one of the members who developed the navi system. Now he designs my guide surgeries. I've already told him that there is someone interested in the markers.
Regarding photo I'll post it after I go to work. Its Sunday night here now.
 
Jaemin Lee

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Can you please go into a little more detail about the marker. Was this part of an appliance made for the CAT scan and then used again for the Trios scan. I totally buy into the improved accuracy, especially in this case where the tooth alignment was really 2D without the markers. Was it fabricated with a plastic shell? Do you have a photo of the marker appliance?
20150922_133457.jpg

Bob,

As you can see, the design of marker is very simple and I think you can make your own very easily.
The company said they are okay with showing you the markers and there isn't any patent on the design of the marker.
They only care about selling more fixtures with this navi system in Korea.

Good luck!
 
BobCDT

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How were they held in place for both the CAT scan and the CBCT scans. Did you make a suck down over the markers for the patient to wear?
Thanks much,
Bob
 
Jaemin Lee

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How were they held in place for both the CAT scan and the CBCT scans. Did you make a suck down over the markers for the patient to wear?
Thanks much,
Bob
No, I didn't.
But I try my best to suck all the saliva up while applying the composite resin on gingiva.
If the gingiva is wet, then the composite can be easily detached.
And I place markers on attached gingiva not on mucosa.
The oral mucosa is movable, so if the markers are placed there, they can be displaced.
In my opinion, there isn't any strict manual for this technique.
Sometimes I attached more than 3 markers on gingiva so that I could use 2 or 1 of them, even some of the markers are detached.
If you try one or two cases, you'd see the attachment between gingiva and composite resin is stronger than you thought.
 
lcmlabforum

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Personally, a duplicate prosthesis, or wax arrangement that should be part of the diagnostic work up, would
easily carry a gutta percha point that is a lot less likely to come off for a high stakes case where you want
to go through the trouble to make a surgical template.
Just saying.
LCM
 
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really really cool case
 
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double post
 
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