video tutorial for exoplan full arch guide

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rshark

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Hi Folks, its been a while since I've been on this forum and there has obviously been a lot going on, the revamped site looks great.
Quick question, can somebody give me a link to a video tutorial that can clearly explain how to plan and make a guide for a full arch (all on 4,5 or 6) case using exoplan? I've trawled through the youtube channel and there are plenty of tutorials for single teeth and bridges but I cant seem to find one for full arch cases. Case in question is a severely compromised patient who has had a failed all on 4 and and now wants to try again with extra implants. Not much bone on an OPG or CT but wants to consider a graft, so what I want to do is just load all the scans and images up to exoplan and do some diagnostics to decide on the extent of grafting required. i have scans with a radiographic stent and a full CT scan as well as upper and lower arch scans. Any help would be greatly appreciated.
 
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Dual scan protocol workflow is not available in Matera, but in an upcoming version.
There is no step by step that I am aware of.
You will have to use all of your exocad wizardry, but one of the best things about exocad is you can invent your own work flow with a little ingenuity. You will definitely have to think outside of the box.
Here's a couple of hints and certainly not a step by step or in any order.

You can pour up the scan appliance like an impression. Before separating the two, scan the appliance as a preop scan then separate the two and scan the gingival surface. This is one way to get the gingival scan registered in proper position to the CT data. If you had both meshes together in a scene and did some creative editing you may be able to save the gingiva with the remnants of the fiduciary markers on the scan appliance as an stl. It may he possible to register this to the CT data as a jaw scan and make a tissue borne guide?
Do your DX work up in CADApp. Save everything (meshes) you need to determine the extent of the necessary grafting in the same coordinates.
Align the scan appliance to the CT data. All the other meshes will be matched as well.
It is possible to convert and save the CT data as a surface. This could be exported and used in another software to make a SX guide especially if the gingiva scan was accurately registered.
Respect anatomy and don't take risks. There are a lot of ways this could go wrong. If you aren't comfortable with making your own way with this version of exoplan there are other softwares with official dual scan work flows that could be used.
 
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rshark

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Dual scan protocol workflow is not available in Matera, but in an upcoming version.
There is no step by step that I am aware of.
You will have to use all of your exocad wizardry, but one of the best things about exocad is you can invent your own work flow with a little ingenuity. You will definitely have to think outside of the box.
Here's a couple of hints and certainly not a step by step or in any order.

You can pour up the scan appliance like an impression. Before separating the two, scan the appliance as a preop scan then separate the two and scan the gingival surface. This is one way to get the gingival scan registered in proper position to the CT data. If you had both meshes together in a scene and did some creative editing you may be able to save the gingiva with the remnants of the fiduciary markers on the scan appliance as an stl. It may he possible to register this to the CT data as a jaw scan and make a tissue borne guide?
Do your DX work up in CADApp. Save everything (meshes) you need to determine the extent of the necessary grafting in the same coordinates.
Align the scan appliance to the CT data. All the other meshes will be matched as well.
It is possible to convert and save the CT data as a surface. This could be exported and used in another software to make a SX guide especially if the gingiva scan was accurately registered.
Respect anatomy and don't take risks. There are a lot of ways this could go wrong. If you aren't comfortable with making your own way with this version of exoplan there are other softwares with official dual scan work flows that could be used.

Sorry for the late reply to you. The information you have supplied is actually really helpful. I'm pretty sure I can make 2 files and align them in the scanning software them import them into exoplan. Your note about the dual scan workflow not available in Matera yet is disappointing I was sold the software by the local vendor with them knowing i wanted to design full arch cases. Truth is the vendor is almost totally useless. When I ask for some kind of guidance on how to do something their immediate response is to tell me to look it up on the wiki. Given you are a beta tester for exocad can you give me a heads up that the dual scan workflow will be available in the Plovdiv version of exoplan? I wont be upgrading until it is. Meantime I'll continue to play around and if i have any luck I'll be sure to let you now. Thanks for your help.
 
2thm8kr

2thm8kr

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Sorry for the late reply to you. The information you have supplied is actually really helpful. I'm pretty sure I can make 2 files and align them in the scanning software them import them into exoplan. Your note about the dual scan workflow not available in Matera yet is disappointing I was sold the software by the local vendor with them knowing i wanted to design full arch cases. Truth is the vendor is almost totally useless. When I ask for some kind of guidance on how to do something their immediate response is to tell me to look it up on the wiki. Given you are a beta tester for exocad can you give me a heads up that the dual scan workflow will be available in the Plovdiv version of exoplan? I wont be upgrading until it is. Meantime I'll continue to play around and if i have any luck I'll be sure to let you now. Thanks for your help.
Shark, sorry for the later reply. I am super swamped and I am under the gun to get a couple of full arch implant cases in the mail.

Full arch cases are possible in exoplan, just not dual scan 'officially' in the Matera version. It may be the next release Plovdiv that has dual scan(?) I can't remember.
exocad never gives a release date on anything not even a best guess scenario. It is released when it is ready. They are unique in the software world and do what they can to drop a stable release without bugs.

If the patient still has teeth and you are going to do an immediate load case, stage the extractions and keep a few for a tooth borne guide, place the implants and shuck the remaining teeth after the implants are placed.
 
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Ok so limited success with the dual scan. I imported the scan model and the rad stent in one splittable file, then tried with limited success to align the model with the visible soft tissue by adjusting the density of the scan. Kinda worked. I have a new strategy next time with the rad stent, by putting way less markers in the stent and making them much closer to the level of the soft tissue. Then I might be able to better align the model in the scan. Problem is to make the surgical guide i need the model to closely align with the soft tissue. Well that's my bit of a work around hopefully exoplan Plovdiv will support dual scan. I'll let you know how my rad guide trick works out, I have another one coming up next week.
 
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