Dental Tribune U.S. Edition

XXXXX a6 Dental Tribune U.S. Edition | March 2014 Industry News By Tarun Agarwal, DDS, PA Today’sdigitalimpressiontechnologyen- ables dentists to create a virtual, computer- generated replica of the hard and soft tis- sues in the mouth quickly and accurately using their choice of optical scanning de- vice. As an ardent supporter of digital im- pressions, I make every attempt to digitize our restorative workflow. There are numer- ous benefits to a digital impression: • Efficiency: A digital impression takes less time than a traditional impression. • Quicker turnaround time: Clinicians of- ten forget or fail to realize the true value of this. Getting restorations back faster is bet- terforthepatient,thepracticeandtheover- all case outcome. • Cost savings: Have you ever calculated the cost of taking a traditional impression for a final restoration? If you add up what yourofficespendsonimpressionmaterials, chair time and case shipping fees, you will be amazed at how much is spent on tradi- tional methods. Case presentation Thefemaleinthiscasehasbeenapatientin our practice for nearly eight years. She has Fig. 1: Preoperative photograph of the patient’s existing longspan PFM bridge. Note the bulky and gray margins, unesthetic contours and ‘patch’ composites used to repair areas of chipped porcelain. Digital workflow used with BioTemps provisionalization Fig. 2: The original abutment preps are cleaned and reduced to the appropriate margin thickness. Ad Fig. 3: A digital impression using the CEREC Omnicam. This occlusal view illustrates how precisely the Omnicam captures a full-color digital impression. Fig. 4: Labial view of the abutment teeth preparations captured with the CEREC Omnicam. Fig. 5: The BioTemps bridge at delivery, seated with provisional cement. a porcelain-fused-to-metal bridge fromtooth#5to#12replacingmiss- ing teeth #7 to #10. She is not terribly unhappy with the look and feel of the bridge, but the bridge has been no stranger to the big issue facing PFM restorations: chipping of porce- lain from the metal substructure. During the past eight years, we have patched vari- ous corners and lingual surfaces. Recently, the patient agreed to replace her long-span PFM bridge with an implant- supported bridge on #7 to #10 and individ- ual crowns on the abutment teeth. How- ever, she was adamant about not going a day without teeth. We advised her that this would not be an issue. Because of the complexity of her im- plant surgery, immediate loading was not possible. This meant we needed a long- term esthetic provisional that would last the duration of the treatment, could be removed for surgery and was adjustable for post-surgical contouring. A BioTemps® provisional bridge (Glidewell Laboratories; Newport Beach, Calif.) was the quick and easy answer. Traditionally,BioTempsaremadepriorto preparation and relined chairside. In this case, I wanted to have the BioTemps made tofitthefinalpreparationsoftheabutment teeth, which would later be converted to individual restorations. As an advocate of digital impressions, I chose to follow a digi- tal workflow. The provisional BioTemps bridge offers these important advantages in this case: 1) Trial smile: Patients get a “trial” of the new contours. Any modifications to length or contour can be made chairside, avoiding costly remakes and unhappy patients. 2) Long-term durability: Because of the complexity of this case, full treatment will take well over 12 months. An acrylic pro- visional fabricated chairside simply won’t hold up this long. 3) Removability: For implant surgery, the specialist will need the ability to remove andre-cementtheprovisionalwithrelative ease. 4) Adjustability: The necks of teeth #7 to #10 will need to be adjusted after surgery toremoveanypressuretothesurgicalsites. BioTemps are easily adjusted. 5) Surgical assistance: The contours and esthetics of the BioTemps will serve as a “guide” to the surgeon for grafting and placement of the implants. As this case illustrates, digital impres- sions are not just limited to final restora- tions, and certainly not just to single units. It’s time for you to take a closer look at digi- tal restorative technologies and see how they can benefit your practice and your patients. About the author Dr. Tarun Agarwal maintains a full-time private practice emphasizing esthetic, restorative and im- plantdentistryinRaleigh,N.C.Youcancontacthimvia e-mail at dra@raleighdentalarts.com or you can visit www.raleighdentalarts.com. HINMAN BOOTH NO. 1825 Photos/Provided by Glidewell Laboratories ways to enhance the program, and for the first time this year, hygienists could nomi- nate themselves for the honor. Nominations could also be submitted by dentists, fellow hygienists, dental as- sistants, professional colleagues and col- legiate colleagues conveying why their nominee is a Pro in the Profession. Addi- tionally, Crest + Oral-B has been at dental conventions throughout the year where applications could be submitted, though nominations were primarily collected via the Crest + Oral-B for Dental Professionals Facebook page. To be considered for the program, nomi- nees had to meet the following criteria: • RDHs with two years or more of clini- cal/professional experience after gradua- tion from dental hygiene school • RDHs who participate in community service • RDHs with examples of work that goes above and beyond the call of duty To learn more about Pros in the Profes- sion, visit prosintheprofession.com or go to facebook.com/professionalcrestoralb. For information about Crest + Oral-B products and resources, visit the updated www.dentalcare.com website. (Source: Crest + Oral-B, Procter & Gamble Co.) “ PROS, page A4