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ePaper created 2017-01-24, 10:47:27 | version 1.38.0
I 17 CAD/CAM 3_2016 clinical_ implant restoration I fice. The workflow is very straightforward and will allow the office to easily fabricate the final crown using familiar techniques with a few changes vs. a tooth-borne crown. _Case presentation Apatientpresentedtoourofficeforfabricationof adefinitiverestorationinthe#30area.AStraumann RC bone level implant (Straumann USA) had been placed and integration confirmed by the surgeon. In order to make scanning the proximal surfaces easier,apre-opscanwastakenwiththehealingabut- ment in place (Fig. 2). The healing abutment was removed, and the matching scan body was screwed into place, tak- ing care to orient the flat portion of the scan body as facially as possible. This flat portion of the scan body is critical for the software to locate the implant position. There will be times that you are unable to fully record the proximal portions of the scan body. These areas aren’t as critical so a bit of missing data here is acceptable. Also, the scan body can be slightly adjusted proximally if needed to allow the scan body to seat properly. Time saver was then used, erasing the healing abutment, and then scanning in the scan body, tak- ing care to ensure the flat portion was accurately recorded (Fig. 3). Opposing and a buccal bite were then acquired. In some instances you will need to remove the scan body prior to capturing the bite. Depending on the depth of placement, the scan body may impact the opposing dentition, so take care to evaluate the position before having the patient close. Either way, the software will have plenty of data to align the bite. Close the case and once the file has saved, click the plus button next to your case to expand the list of files. Click the DDX export button (Fig. 4), which will take you online to the DDX portal. From the lab list,selectthelaboratoryyouwishtouseandyouwill bring up its lab prescription form (Fig. 5). Fill out the details for the digital prescription; the patient name will transfer over to the online form. From there, indicate the implant type, desired ma- terial for the abutment and any applicable surface finish. Dentists will also be able to indicate how they prefertherestorativemarginbeplacedrelativetothe tissue. Typically, settings would be to have the facial margin 1.5 mm subgingival, the proximal margins equigingival and the lingual slightly supra gingival. The laboratory returns the abutment and screw alongwithaprintedmodelwithanaluminumanalog (Fig. 6). Fig. 2_ Pre-op scan. Fig. 3_Scan body scan. Fig. 4_DDX export. Fig. 5_DDX online prescription form. Fig. 6_ Printed model with aluminum abutment analog. Fig. 2 Fig. 3 Fig. 4 Fig. 5 Fig. 6