Use of 3D printing in implant cases

Adi

Adi

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Hi
In implant cases all on 4 or 6, it's always a hard multiple tasks to go through:

1. Analog fixed in the impression.

2. Bite registration

3. Try_in acrylic teeth to make sure that the bite is right

4. Wax up and casting

5. Metal finishing

6. Metal try_in

7. Ceramic work

8. Ceramic try_in

9. Finishing

I think that 3D printers made a short cut in this trip specially for step 4 and 5, as it's done by CAD, and the metal finishing is very easy because it's either printed by a laser printer or printed in castebl resins .
Step 8 can also be skipped if a provisional was printed and tryed in the mouth, which is the best part, because you reduce the same teeth that was tried in the mouth. And you make sure the bite is right.
Any other short cuts?
 
Contraluz

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Don't skip the verification Jig! Also, printing implant models has its difficulties, too. Make sure your analogs fit snug!

Many times we do a PMMA try-in for esthetics and bite confirmation, which can be modified easily. It then works as a 'bite rim'.

finishing is very easy because it's either printed by a laser printer or printed in castebl resins
Do you have previous experience with SLM? I ask because my experience is not the best, so far. Warped structures and porous finishing. And just because you print/mill your structures in castable resin/wax doesn't mean your cast is free of trouble! It can still warp and come out porous.
 
Adi

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Don't skip the verification Jig!
Nm3.jpgI don't skip the verification Jig, I do it first thing, I make an acrylic bar on all transfers, then section them, back to the doctor to attach them all using pattern resin and then take the impression one last time.
 
Adi

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which can be modified easily.
How can it be modified easily? Any modifications means redesigning! Unless it's just grinding a little.
I use an acrylic teeth setup, if it needs modifications I just melt the wax that is fixing the teeth and drag or tilt or whatever.
Then scan them as pre_op to design the provisional accordingly.
 
Contraluz

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How can it be modified easily? Any modifications means redesigning! Unless it's just grinding a little.
I use an acrylic teeth setup, if it needs modifications I just melt the wax that is fixing the teeth and drag or tilt or whatever.
Then scan them as pre_op to design the provisional accordingly.
Well, once all the adjustments are done, re-articulate the models, using the PMMA as 'bite rim'. Then you need to re-articulate the digital models (redo your articulation scan). Once you have the new bite situation in your designing software, adjust the occlusion on the design.

Although, if the discrepancy is minor, I may as well only adjust the final product, after milling/sintering.

I hope this makes sense...
 
Adi

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Well, once all the adjustments are done, re-articulate the models, using the PMMA as 'bite rim'. Then you need to re-articulate the digital models (redo your articulation scan). Once you have the new bite situation in your designing software, adjust the occlusion on the design.

Although, if the discrepancy is minor, I may as well only adjust the final product, after milling/sintering.

I hope this makes sense...
Yes it makes sense thank you.
If we're talking about posteriors then yes it is easy to modify, but I was talking about anteriors, last case I had there was a huge difference in the middle line and tilting in teeth, so I think it was easier with acrylic teeth.
 
Sda36

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View attachment 38488I don't skip the verification Jig, I do it first thing, I make an acrylic bar on all transfers, then section them, back to the doctor to attach them all using pattern resin and then take the impression one last time.
Certainly not an articulator I would choose on such a complex and expensive case to the Patient. Just sayin, really??
 
Sda36

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Certainly not an articulator I would choose on such a complex and expensive case to the Patient. Just sayin, really??
Everyone of those chrome type articulators has a given flaw in arc of closure and lateral deviation. Not to mention no relationship at all to the human structure of the tempro mandibular structure and related movements - none are even close. Did you ever wonder why there were finer instruments, face bows, pantographs?? I really don't want to cloud up and rain all over you but seriously look into tools that perform more like humans, in all planes. As I once stated here," The mandible is a 3 dimensional object moving through space and time" Dr. Di Pietro. A Massive amount of work went into That was an chapter in " Full Mouth Rehabilitation" Volume ll Dr. Max Kornfeld Publisher.
Try to understand what we face trying to imitate close to actual human madibular functions. The Maxillary is fixed, planes are fixed to that postion, facebow. Next comes the moving factor, the madibular movements. How much available setting do you have? What is a predictable range if motion? A lot of these modifiable settings are available on semi adjustable articulators. Research and purchase. Can't give any weight to much less and believe me I've used and discarded plain hinge articulators. Use only for simple repairs where No records are included.
Sorry for the rant, had a tough day.
 
Adi

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Certainly not an articulator I would choose on such a complex and expensive case to the Patient. Just sayin, really??
What's an articulator have to do with impression taking?
 

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