October 29, 2019
Good news! Elos Accurate Hybrid Base Engaging is now available in 3Shape Implant Studio. For all dental professionals out there who love digital dentistry, this means your workflow is now more simplified than ever. I spoke to Oral Prosthetics Specialist Bjorn Gjelvold who recently carried out dental implant surgery on a patient using this new digital workflow. In this blog post, he shares his thoughts and experiences.
Sure. I am an Oral Prosthetics Specialist at the Swedish Public Dental Service (Folktandvården Skåne AB) with a great interest in digital dentistry. In my daily practice, I use digital equipment such as intraoral scanners, CAD/CAM software and 3D printers. I also carry out studies and research in implantology as part of my Ph.D. position at the Faculty of Odontology at Malmo University.
This means I can now do more things in the software. 3Shape Implant Studio is a tool for both implant planning and creating a surgical guide. And now, with Elos Accurate Hybrid Base Engaging available in the software, it is also possible to design the tooth that is going to sit on top of the implant. This includes temporary screw-retained crowns or customized healing abutments. Moreover, all of this can be done in one single workflow prior to the patient’s surgical appointment.
It means I can do everything from planning the implant placement, creating a surgical guide and designing the prosthetics without having to jump between software. This allows for a much more efficient workflow and same-day implant dentistry. I can scan my patient in the morning, plan the implant position, design the surgical guide, healing abutment or temporary crown and produce the components – all in the same day. So when the patient comes back for surgery in the afternoon, I will have a custom solution ready for that patient.
Many of my implant cases I do together with my friend and college David Reinedahl, Specialist in Oral and Maxillofacial Surgery. Our patient was an elderly man who was missing both of his front teeth. We did a CBCT scan and took a digital impression of his teeth using an intraoral scanner. We imported the files to the 3Shape software and planned and designed everything using this new simplified workflow.
First, we planned the implant placement in the software. When the implants were in the correct place, it was time to design the surgical guide that was going to be placed in the patients’ mouth during surgery to accurately place the dental implants. The next step was to design the dental restoration using the Elos Accurate Hybrid Base Engaging components.
In this case, we decided to design two temporary screw-retained crowns and two customized healing abutments. We 3D-printed the surgical guide and crowns in materials specific for the components’ intended use. We cemented the crowns and healing abutments onto the Elos Accurate Hybrid Base Engaging components.
By doing both screw-retained crowns and customized healing abutments, we could choose between either installing the crowns immediately or using the healing abutments first. We wanted to make sure we had the best possible solution available for the patient on the day of the surgery.
Of course, you could say why not just go with standard healing abutments? In this case, it was better to use a customized healing abutment. A customized healing abutment allows for patient-specific soft tissue management during the healing phase and a final restoration that adheres precisely to the patient’s gingival architecture. In 3Shape, we could design the emergence profile optimally for our patient’s anatomy and adapt the gingival height to our patient to achieve a stable and highly aesthetic result, so that when it was time for installation of the permanent crowns, they would fit perfectly.
We ended up going with customized healing abutments due to the fact that we did not reach our clinical requirements for immediate loading. The procedure was predictable and comfortable for the patient and he was very happy with the end result. The first postoperative healing control showed a great soft tissue healing already. The last step is to manufacture and deliver the final prosthetic solution.
The dentist or surgeon must be experienced when carrying out technical procedures that include many steps. The more steps the more accuracy is required. It is also important to be a bit cautious. This new improved digital workflow provides a wide range of choices and possibilities for dental professionals. However, you should not do these procedures just because you can but instead make sure your patient meets the criteria of the treatment. Focusing on the patient’s needs and creating good results should be your top priority.
Today, we can design a restoration in a computer, 3D print or mill it, and install it in the patient’s mouth, all in a matter of hours. That is pretty amazing. As digital dentistry continues to advance with new techniques, workflows and materials, I think we will be able to provide patients with better, more cost-efficient and individualized dental solutions. I hope patients will no longer have to pay ridiculous amounts of money for good teeth.
Global Product Manager/ Dental at Elos Medtech
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