May 2, 2018
In one of our latest blog articles, we announced that we are phasing out Cresco products to focus entirely on our digital workflow solutions. Dental technician Johan Oxby and his colleagues at Team Oxby specialize in dental implant treatments and have a passion for new technology. With a close cooperation between the dental clinic and laboratory, they use a completely digital workflow to renovate old Cresco bridges.
My colleagues and I at Team Oxby used Cresco for many years to create screw-retained bridge restorations. My father Gert Oxby, who founded Team Oxby in 1983, also worked as a product developer at Cresco which made the method a natural part of our work. At the same time, the digital technologies in the dental industry developed rapidly back then, and still are. Early on, my big interest in new technology made me see the many benefits of embracing a digital workflow to complement and replace conventional restoration methods.
In 2009, we invested in a 3shape scanner for our laboratory. From there, we have been going through a transitioning period from working with dental implants the conventional way, with a wax-up and a casted bridgework, to designing and milling a construction entirely in-house. At first, we entered the digital workflow by scanning the models at the laboratory. Today, our clinic uses an intraoral scanner and scanbody to create digital impressions of our patients’ teeth. Of course the laboratory is not only serving the clinic of Team Oxby, but also other clinics located nearby.
For us, the main benefits of transitioning to digital technology have been higher productivity, precision and reliability. The beneficial elements of Cresco are still available in the digital workflow but with added features to get even better results. Consequently, we can create even more aesthetically appealing results with a higher quality to our patients, which is the most important aspect.
Compared to other methods used at the time when Cresco was developed, it enabled us to create longer-lasting bridge restorations. However, since an old Cresco bridge restoration is made up of plastic that surrounds metal, it is still more prone to breaking than a full anatomy construction made of one coherent material. So, after a number of years, the acrylic part of the restoration may start loosening even though the bridge itself is intact and functional. Therefore, it has been important for us to be able to renovate old Cresco bridges with digital technology.
The process starts by detaching the old bridge from the patient. Often, we need to renovate the bridge due to lack of, or doubtful, gingival adaptation and sunken/lowered occlusal plane. In this phase of the workflow, the renovated bridge is ready to be presented to the patient. But we want to upgrade the existing construction with the following criteria; A recognition for the new bridge (copy of the old), a monolithic construction, to end fractures that occur on metal and plastic constructions as well as design and improve the copy.
A model is made to determine the position of the implants to the new bridge. The old renovated bridge is then copied with the lab scanner and turned into a digital file. Additional design work is then made in the digital world if it is needed. After copying the original bridge, it is reassembled in the patient mouth. The construction is milled in-house, in monolithic zirconia with titanium bases as precision to the implants. This entire procedure is really straightforward and usually does not require more than two visits by the patient. We conclude it in one working day. We remove the bridge from the patient in the morning and at the end of the day, the patient gets it back. Then we have time to recreate and upgrade the construction since the patient already has a working bridge “the old renovated one”. This tight workflow is enabled by us having the clinic and laboratory under a single roof, and that is our strength really.
The picture above shows one of our patients who has undergone this treatment. We used Elos Medtech’s prosthetic solution Elos Accurate Hybrid Base Bridge together with the corresponding Elos Accurate Libraries to our scanner software to access the dental components. The end result is an aesthetically appealing restoration with a perfect fit. For the patient, the design and “feel” of the new bridge is exactly as comfortable as the previous one. In addition, because it is a full anatomy construction made in a single material, it is highly durable.
The process requires some initial investments in time and money. Still, if you have the right tools to work with and someone to guide you through the transitioning phase, you will be up and running quickly. At team Oxby, we use a completely digital workflow with an intraoral scanner, scanbody, CAD software, dental libraries and a milling-machine. With that said, it is not necessary to invest in all of these digital technologies at once. Take it one step at a time if that suits your business best.
At times, I hear concerns from dentists and dental technicians who are worried that they will lose the handicraft of their profession if they implement a digital workflow. My view is that this is not the case at all. The handicraft is still there but with a different focus and touch than before. You will continue to use your existing expertise, knowledge and experiences and build upon these in the digital environment. Initially, the biggest challenge for me was to go from waxing models by hand to doing it digitally. It takes practice, but it is worth the effort. Once you are waxing digitally, you benefit from the help you get from the CAD software and the dental libraries. That way, it is easier to get an optimized shape, and a smooth prosthetic process at large!
I hope this blog article provided you with knowledge and inspiration to develop your own digital workflow. Feel free to share this blog article on social media, contact us with any questions or visit our website for more information.
Business Development Manager & Technical Adviser Elos Medtech AB