All On Six in 3 Hours

187 Rating(s).


Posted on By armando ponzi In Digital Scanning & CAD/CAM

Patient received a superior prosthesis in occlusion and adapted to mucosa. The prosthesis was modified and a bite was used for X-Ray exam and for accurate surgical stent fixing on bone.
After the planning, a 'universal' type stent , was produced inhouse with a 3D printer.
The surgical procedure was flapless and it was possible to immediately place the multiabutments and cylinders on top.
Cylinders were immediately attached to the modified prosthetic and screwed to the implants.
We were able to complete the entire procedure within 3 hours time and patient walk out the office with prosthesis on.
I believe that digital planning could be a valuable tool, reducing time and simplifying surgical and prosthetic procedure, expecially on immediate loading.
What is your opinion about it?

Prosthetic and inhouse stent
Stent positioning with bite

Drilling and positioning transversal pin
mucotomies


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16 Comments

Dear Dr. Ponzi,

The case looks excellent and digital dentistry is proving itself time and again. Which brand and model is your 3D printer since I plan to invest in that but it is a difficult choice :)


Reply

Kalin, thanks for the kind word. The 3D printer I have got is 020D by DWS: very precise and affordable in terms quality/pricing ratio. Armando


Reply

Armando, great CASE. I also I´m interested in your advice about oral scanner and digital process.
Thanks
Jorge


Reply

Great stuff....and I agree completely. You stabilze the GUIDE against a Bite registration with lower arch? Do you do the same when seating the provisional? Perhaps time for a XP presentation or Case report? Thanks Mo


Reply

Armando,

Clean and concise
Few questions- X-rays or CBCT?
Seeing that you did with flawless, what height multiunits did you use? compensate for resorption- all multi u are same color except 1 - does that indicate all same degrees?

What is the set up in the mandible?

Cheers,

RIchard


Reply

Martin I'm adding some more picture below of the planning .


Reply

Martin, as you can see on the planning the implant 26 had an angle of about 18° that was corrected with the correspondent angulated multiabutment(in silver). The multiabutment lenght can be measured on the planning as you can see on the picture and order the right neck in advance. Lower arch is going to receive same treatment and planning is almost ready. Thanks for your comments. Armando


Reply

Maurice, you are right, the bite is the key, the interface that I use to replicate digital , surgical and prosthetic plan. So, step 1 is when taking the CBCT step 2 when fixing transversal pin step 3 when fixing the cilinders to the prosthetic. I'm quite busy now but I keep on mind to share some of these experence on Dentalxp, hope soon. Good to be here with lots of friends and incredible professionists all over the world. Armando


Reply

Jorge, you are too busy on pure surgery to do something else..:) but we all love that. If you want to initiate the digital adventure let me know. Ciao. Armando


Reply

Nice workflow Armando!
What software did you use to design the guide? How do you plan to fabricate the final restoration?


Reply

Anton, we use Simplant for general planning and for specific stent design and production an open source software. How do you plan to fabricate the final restauration? I'm sure you can help on that field, so let me know your valuable opinion about it. Best regards. Armando


Reply

Great work Dr.Armando, lot to learn from your digital work in this field, thanks for sharing.


Reply

Ashok, thanks for kind comments. I'm glad you are enjoying it. Armando


Reply

Armando. EQUISITE PLANNING AND EXECUTION! An outstanding service for your patient. Do you feel this approach can be incorporated into a referral based practice? Thank you for sharingWarm regards. Chuck


Reply

Chuck, thanks for your comments. Is this useable for referral? honestly I don't know. I believe though that planning concept could be an evolution and more complete experience sharing on referrals. Armando


Reply

Amazing case, Armando. I have long thought that 3D printing will eventually take the place of many of the techniques we now use. How do you see the future of 3D printing in dentistry?


Reply

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