Digital Denture Case: Start to Finish
Over the past several months we have published several articles about digital dentures. I have provided these articles below if you wish to read these articles.
This week I will show the beginning phases of an actual case and follow it through to finish in a three-part series.
Let's get started.
Digital Denture Case Workflow Content
Digital Workflow Case
This particular case came to Burbank Dental Lab as a first test case from a doctor that wanted to begin to work in a digital workflow with the hopes to cut the number of appointments and increase the accuracy and comfort for his patients.
He wanted a workflow for his patients with existing dentures that he could complete in 3 office visits. The workflow that Burbank is providing this doctor is as follows:
Clinical Procedures for Initial Impression Appointment
First the doctor took a PVS reline impression in the existing old denture.
Prior to scanning, he powder-sprayed the relined denture.
Next the doctor scanned the denture with his IOS and took a bite scan with the relined denture in the mouth, as well as a scan of the opposing arch.
The .stl of the scans were then transmitted to the lab
Clinical Procedure for Teeth Try-In Appointment
Since the try-in was milled from the digital impression file, little to zero undercuts need to be blocked out since it never has to be seated on a model. This results in a bite-block (when needed) and teeth try-in prosthetic that fits exactly as the final denture will fit. (Even better than the conventional final denture.)
Try-in for this type of digitally fabricated (printed or milled) teeth try-in involves what you would expect: checking for an occlusal relationship, proper vertical, tooth placement, as well as being able to accurately confirm speech issues. It also allows for confirmation of fit and comfort. Take note that if the fit is loose in any way, a wash reline is recommended at this appointment so that the final prosthetic can fit more precisely.
You should also understand that typically digital dentures will not have nor need a post-dam to be part of the design as the fit alleviates the need for a post-dam to enhance suction.
Perform any occlusal adjustments at this time, and they will be copy milled into the final denture.
This case has now been tried in and was a successful fit with minimal adjustments. The doctor actually commented that the try-in fit extremely well. We have never heard a doctor comment on the fit of a try-in as we all have come to know that try-ins were for occlusion and tooth placement and that the fit was a hoped-for result in the final denture. NOW the fit is part of the equation for a try-in.
Burbank, CA 91504
- CBCT imaging
- BSB Plan software treatment workup
- Meshmixer design to 3D print
- Using various 3D printers for surgical guides, dentures, temps, models, jaws
- Bone grafting and immediate implant placements
- Soft Tissue Augmentation
- Fusion Bone Binder
- PRF (Plasma Rich Fibrin) and its role in wound healing
- Surgical skills to execute full arch therapy in a timely manner, decreasing chair time