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CAD/CAM - international magazine of digital dentistry, Italian Edition, No. 3, 2015

3_201514 special _ digital technologies Once the patient has accepted the treatment plan, we proceed with a functional wax-up. The functional wax-up will guide the treatment of the patient. It will enable us to visualise the final resto- rations. At this point we can decide exactly what will be: the ideal implant position; the ideal abut- ment; the ideal restorative material; the ideal shape of the restoration; the need for grafting (hard and soft tissue). The easiest way to achieve the most precise functional setup is by using the Arcus Dig- ma (KaVo; Fig. 2). It is the only system that enables you to make a very detailed motion analysis (10 mi- crons) that replicates the jaw movements exactly by utilising computer technology. Arcus digma has a bite-fork that makes it easy to position the upper jaw in the articulator. A fully ad- justablearticulatororadigitalarticulatorispreferred. ItiscriticaltogetaperfectbiteregistrationinCR.The functional wax-up can be generated semi-automat- ically in the CAD/CAM software by using the data gathered from the models and functional move- ments. Alternatively, we do it the old fashioned way by adding wax to the stone model. (Note that the precision of the wax-up will reflect the care taken to acquire the diagnostic information.) With the wax-up approved by the dentist, the placement of the implant can be performed in the cone beam imaging software. We use the OnDe- mand software by Cybermed Inc. The software has a fair price. It can handle all DICOM based cone beam images. The In2Guide plugin (in OnDemand) enables you to do the implant planning with what- ever guide system you prefer (i.e. Straumann, Nobel Biocare, Zimmer, etc.). Usually we use the univer- sal drill kit developed for the In2Guide system. It gives the user the ability to place any implant on the marked with this single drill kit. The only brand specific tools needed is the implant driver and a Fig. 3a Fig. 3b

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