Part 1.LOWER IMPLANT FIRST MOLAR 8-MINUTE 3SHAPE CAD. Andrews RRR

128 Rating(s).


Posted on By Anton Andrews In Digital Scanning & CAD/CAM

Straight forward single molar implant replacement case.
7X10mm wide diameter immediate implant. 3-months post insertion appointment for combined uncovery and intraoral scanning. CAD was done for Andrews RRR - Reverse Restorative Rehabilitation Protocol.
It took 8 minutes from start to finish.
STL file was sent to a milling center to CAM full contour zirconia restoration.
Future is now.
Comments? discussion..

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20 Comments

Beautiful! I like the software! Anton, can you share your video on https://www.facebook.com/groups/cerecinrussain/ please. Thank you! Gregory


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Very impressive....the future is here. Dr. Salama


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Thank you guys for compliments.
To my shame, I have to admit that I do not use facebook.
Gregory you can use this link on youtube to share:
http://youtu.be/NRhwpUf-jdY


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Andrew,
you' ve done a really nice crown planning. My compliments.
My only 3 concern on this type of work are:
-Tbase has a fix height and doesn't allow flexibility in several circumstances.
-although you have done a very accurate work you have a critical area,the round mucosa profile to be connected to the elliptic crown one.
-A customized abutment IMO could allow better flexibility and gingival margin control
But, on other hand having an engeneering system that could lead to the digital planning the way You do, is time and cost savings and improves the accuracy.
Thanks for sharing, I'm older than You are and I am pleased that new generation has these vision of digital work, which is, as you say, future now.


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Armando, thank you for compliments and concerns,
please see those addressed below:

My only 3 concern on this type of work are:
-Tbase has a fix height and doesn't allow flexibility in several circumstances.

Since I started using ti-base I have done couple hundreds 100% digital CAD/CAM implant restorations and the height of the ti-base was never an issue.

-although you have done a very accurate work you have a critical area,the round mucosa profile to be connected to the elliptic crown one.

This is critical area and designed with Andrews RRR to ensure long-term stability of the FGM around the restoration.

-A customized abutment IMO could allow better flexibility and gingival margin control

a restoration designed with Andrews RRR incorporates a custom abutment because emergence profile is customisable thus "classic" concept of a custom abutment + crown is redundant for most of the cases, including anteriors.
Besides my crown is screw-retained (the gold standard nowdays) , without any cement-related complications.


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I am starting to realize, that most of the doctors who watched the video do not understand what is going on here.
The gingiva will be shaped by the FINAL crown, there is no temp, healing abutment was placed AFTER the scanning was completed.


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Anton. Your work is spectacular! I wish lab technicians had your knowledge(especially for management of emergence profile). Yes,when implant inclination/position permits screw retention,your approach is ideal. However, I don't find screw retention always be possible (or perhaps ideal) in many maxillary anterior cases. That is when a custom abutment / provisional crown would be helpful. Does you software provide templates for abutments or do you need to manually convert a crown template into an abutment if an abutment is desired? Thank you sharing. Best regards. Chuck


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Thank you Charles.
First of all, there will be not many lab technicians/labs left soon.
I could say for myself that I will never go back to rely on them for my restorative work.

Regarding anterior restorations, my Andrews RRR protocol is universal and could be used anywhere, unless an implant angulation is really wacky. I use it on single, multiple single, bridges, AO6 you name it.

I will post a case for the central upper incisor soon.


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CONGRATULATIONS!
Thanks for showing us what you do, and how you do. I would like to copy EXACTLY the same way!.
I´m old enough, as Armando, but I think I can learn.
Thanks for inspiring to the non-digital group to change.
Jorge


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Thank you Jorge,
your work is also inspiring!


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amazing Anton!
I must say very impressive, you need some digitale edit skills I suppose? Is this a long learning curve?
The only thing what got neon my nerves was the music ;D
It only lasted 4 minutes thank God
Regards,

Haakon


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Thank you Haakon,
sorry couldn't satisfy you with the music, didn't know that you don't like Mozart...


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One of the way is utilize digital dentistry in your surgical protocol especially on anterior single implants is to scan the tooth before the extraction if you happy with anatomy. It also gives you the shape of your future custom abutment or screw retained restoration. I usually have portable hard drive when I scan the tooth if I'm not planning to do immediate load and use that scan as my biocopy. It is very easy and very predictable. Gregory


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Gregory,
thank you for the suggestion,
3shape has a preliminary scan feature as well as the option to copy the other tooth shape to be used for the design.


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Recently I'd started implementing 2-visit concept for implant treatments.
It means that from the point where a patient has a failed tooth to the final implant crown delivery it takes only 2 1-hour long appointments .
Not counting the post-ops, x-rays, suture removal etc, which could be done by a DA


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Brilliant work Anton,

Where do you get your scan bodies from, nt trading?

Regards


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Thx Andoni,
Yes, so far I've been using not-trading, but also looking for alternatives.


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I find them to be wide for narrow spaces, and the ti-bases to be too flared, about 1 mm wider than the implant platform on each side.


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EX For zimmer 3.5 mm platforms . Yes I agree. I am switching for that reason to different implant system as well.


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We need more doctors like you Anton, because the technology is there but so many things have to improve. Until we actually dive into the digital world we don't realize that there are a thousands little obstacles that we have to jump over.


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