Equipment & Technology Buyers' Guide - October 2021 - 4

FEATURE ARTICLE
Blueprint: Fully Digital Implant Workflow
with Dentsply Sirona's Axeos 3D
Imaging System
By Dr. Daniel Butterman, International Congress of Oral Implantologists Fellow
and Resident Faculty Member at CDOCS.com
(Continued from page 1)
Improving implant surgery
Dentists sometimes focus on the implant first and putting
the implant in the right position but when it comes to
putting the tooth in, then they run into trouble. If the
implant isn't in a position where it lines up with the crown,
the lab might not be able to create a properly angled
abutment, or the screw access position will be in the wrong
place. To avoid these issues, you need to evaluate the
space for the implant, but just as importantly, the space for
the restoration. It's difficult to judge by eye if a properly
contoured crown will fit in the space. That's why it is
important to design an actual crown into the future
implant space.
Merging together three-dimensional imaging view from
Axeos and a scan from a CEREC Primescan will show you
exactly how much room you actually need. Without 3D
imaging, it's possible to lose perception when free handing
an implant, and end up with disastrous results. This is either
due to not having a plan of where the implant should go
or not having an easy way to execute on that plan during
surgery. It is important to have both of those pieces to avoid
those situations.
Saving time
In a typical analog/2D workflow when someone has missing
teeth, the process would typically involve:
* Taking an impression and sending it to the lab for
a diagnostic wax-up
* Taking an x-ray to see where the teeth are in relation to
the bone
* Getting a barium sulfate scanning dye
* Requesting a surgical guide from the lab
By the time the patient says they are interested in getting
implants, they've already had to wait many weeks and
spend several hundred dollars just to do the planning.
Especially in the age of digital and CAD/CAM dentistry,
patients are expecting things to happen very quickly, and
aren't okay with things taking this long.
Daniel Butterman, DDS
Guided surgery workflow
It's much more efficient to use 3D imaging, to save time and
to avoid any surprises. In our practice, we use the CEREC
Guide 3, which is the latest version of guided software from
Dentsply Sirona. It's compatible with our Axeos CBCT and
Dentsply Sirona implants.
If a patient comes in with a missing molar, the first step is to
talk with them about how we can potentially restore it. The
workflow includes:
* Taking an Axeos scan to understand the biology. The
Axeos 3D Imaging System has automatic positioning,
so patients no longer need to hold still while scans are
taking place. This helps eliminate poor imagery due to
unintended movement.
* Having my assistant take an optical scan with the
Primescan system. This captures the area where the
patient is edentulous.
* Automatically creating a crown proposal. At this point we
can show the patient what the crown is going to look like,
and explain different options.
* Importing the crown design into the patient's x-ray. This
will show us if they have enough bone for the implant.
If we need to perform grafting, we can show the patient
this in the 3D image so they can better understand why
it's needed.
Once the implant is designed, we move to the
manufacturing phase to see what the block looks like, and
then mill it out. This takes roughly 35 minutes, and can be
done live in front of the patient. From there, we manufacture
the CEREC Guide 3 and place the implant.
The advantage of this system is that you can perform fully
guided osteotomy and fully guided implant placement
without using keys. Most guided surgery systems require a
long key to shrink the diameter of the guide hole for each
consecutive drill, and that can be cumbersome. The Astra
EV Guided Kit we use has a miniature sleeve on the drill that
makes this process much easier.
4
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Equipment & Technology Buyers' Guide - October 2021

Table of Contents for the Digital Edition of Equipment & Technology Buyers' Guide - October 2021

Index
Equipment & Technology Buyers' Guide - October 2021 - Cover1
Equipment & Technology Buyers' Guide - October 2021 - Index
Equipment & Technology Buyers' Guide - October 2021 - 3
Equipment & Technology Buyers' Guide - October 2021 - 4
Equipment & Technology Buyers' Guide - October 2021 - 5
Equipment & Technology Buyers' Guide - October 2021 - 6
Equipment & Technology Buyers' Guide - October 2021 - 7
Equipment & Technology Buyers' Guide - October 2021 - 8
Equipment & Technology Buyers' Guide - October 2021 - 9
Equipment & Technology Buyers' Guide - October 2021 - 10
Equipment & Technology Buyers' Guide - October 2021 - 11
Equipment & Technology Buyers' Guide - October 2021 - 12
Equipment & Technology Buyers' Guide - October 2021 - 13
Equipment & Technology Buyers' Guide - October 2021 - 14
Equipment & Technology Buyers' Guide - October 2021 - 15
Equipment & Technology Buyers' Guide - October 2021 - Cover4
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