IOS for edentulous cases help.

[mightymouse]

I have young doctor who prefers IOS and hasn’t had much experience with dentures. The doctor wants to take IOS for removable denture cases. I know for immediates with existing teeth not an issue as we have teeth to occlude, which allows us to establish a vertical. My question is what is your view/ process with an edentulous IOS. Taken classes where they say it depends on the scanner, others say doesn’t matter what scanner as compression is key and scanners can’t achieve compression. I would love to hear your views. I’m using exocad if anyone has specifics for me to follow.

 

[bigj1972]

Tell him welcome to the real world. Get some impression material and trays....They told him he could do removable just to get his check for the scanner..

 

[sidesh0wb0b]

from the scans ive seen of 8-10 ios systems, i dont feel this technology is there yet. tissue moves too much, and stitching the data together across the arches causes concern at the very least. not to say it cant be done, because it "can"
but do you really want to put your name on those? for me, the answer is no. we have the capability to do them, we turn them away. heck, we have even made a few, and they have been in place for years now. i prefer to sleep better at night with the products i am comfortable standing behind

 

[bigj1972]

Yeah you "can" super glue a tooth back on a Valplast, but do you call it repaired.

 

[Cleo]

I agree with everything previously mentioned. I do a lot of these (I would prefer traditional methods) and I request a wash impression taken at the final try in. Some offices can get a better scan than an impression.

 

[JonnyLathe]

3shape says it can be done with a very specific workflow, call me extremely skeptical but curious. Next simple denture patient I get I'm going to offer to make them a completely digital denture with IOS and minimal analog to experiment and a traditionally made one with custom tray/border mould impressions, waxup and ivobase processed to compare.

 

[bigj1972]

Better yet, double the fee for traditionally made one with custom tray/border mould impressions, waxup and ivobase processed.... Then if they want the cheap one, print it. My guess is if you know how to do all that, you're worth more than what can come out of a bottle.

 

[Denture Dude]

3shape says it can be done with a very specific workflow, call me extremely skeptical but curious. Next simple denture patient I get I'm going to offer to make them a completely digital denture with IOS and minimal analog to experiment and a traditionally made one with custom tray/border mould impressions, waxup and ivobase processed to compare.

had a chance to try this experiment?

 

[JonnyLathe]

had a chance to try this experiment?

Not yet, I'm waiting for the right patient. Can be tough with denture patients. I'm waiting for someone with a relatively simple class I bite and good attitude/resilience. Lately I've had a bunch of tough denture cases!

 

[zero_zero]

Perhaps @rkm rdt has some valuable info to share ?

 

[rkm rdt]

I love IOS scans for partial dentures
Hands down more accurate than an alginate or pvs.
However for complete edentulous cases it is probably easier for the unskilled dentist to take a conventional impression and use a custom tray.

 

[CWilliams]

The only way I would attempt this is with an immediate bc they have to be relined post op- never for a complete final. It's similar to trying to scan a fully supported implant prost., 1) the fit was never accurate the times we've tried and 2) you can't accurately achieve a VDO. We've tried sectioning temps for bite support and bite blocks etc but you really need to scan the complete arch to accurately p/u a bite to make sure there isn't any cant or misalignment. To note we have a 3shape trios. IMO Analog is the only way to go with these types of cases or a hybrid of new and old. Tech is great tool for many parts of the flow but solely used for a complete start to finish? It's just not there yet, at least for the doctors that want high quality and efficient appts.

 

[JonnyLathe]

The only way I would attempt this is with an immediate bc they have to be relined post op- never for a complete final. It's similar to trying to scan a fully supported implant prost., 1) the fit was never accurate the times we've tried and 2) you can't accurately achieve a VDO. We've tried sectioning temps for bite support and bite blocks etc but you really need to scan the complete arch to accurately p/u a bite to make sure there isn't any cant or misalignment. To note we have a 3shape trios. IMO Analog is the only way to go with these types of cases or a hybrid of new and old. Tech is great tool for many parts of the flow but solely used for a complete start to finish? It's just not there yet, at least for the doctors that want high quality and efficient appts.

I hear you, good to know. I'm thinking my workflow will be primescan, print baseplate (or model to make lightcure baseplate), make wax-rims and take a wash to throw into the desktop scanner.

Right now all of our final dentures are completely analog and likely will continue to do so until we can mill them (we just have 3shape and an Asiga at the moment). I wouldn't put someone into a final denture that's printed.