Comprehensive Single/Quadrant Implant Workflow

Full-Arch Implant-Supported Cases: The Beauty of All On 4

Google “All On 4,” and over 25 billion results appear. This treatment option is a fast-growing area of dentistry. The concept of All On 4, also known as full-arch implant-supported

Choosing the Optimal Dental Material: Zirconia vs. E.max

The goal of any dental restoration is to restore the patient’s oral environment back to its natural or improved appearance and functionality. Dental materials have come a long way since porcelain

Managing Patient Expectations: IPS e.max Restorations

The overall quality of care in dentistry is measured by clinical outcomes and overall patient satisfaction. While clinicians are often concerned with patients’ dental health as a whole, patients can be

A Guide to Perfecting Veneers

One of dentistry’s most difficult esthetic challenges is matching single anterior veneer restorations to the existing dentition. In many instances, cases like these may require several attempts to achieve an

The Benefits of E.MAX Restoration: A Case Study

Case Study: Case Fabrication The case was then ready to be designed according to Dr. Estwani’s instructions. One of the great benefits of a digital workflow is that the proposed

Implant-Assisted Removable Partial Dentures

Partial dentures are one of the treatment modalities that are underused in today’s dentistry despite being a good choice for many patients.

Full Mouth Reconstruction: The Pathway to Success

One of the most challenging undertakings in dentistry for both the clinician and the laboratory is a full mouth reconstruction. For patients who present with excessive wear of their dentition, a full mouth reconstruction is critical in re-establishing functional harmony, pulpal health, esthetics, and protecting the dentition from further damage.

Optimized Treatment Planning: A Case Study with E.max Restorations

A case study on the steps to a full mouth rehabilitation with Dr. Isam Estwani and the Smiles By Design team at Burbank Dental Lab.

Single Implant Abutments - Conventional Workflow

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1
Initial Impression Appointment

1. Initial Impression Appointment

2
Pre-Operative - Creating a surgical stent

From Lab - Wax-up - Wax-up of the teeth in the area(s) of the proposed implant restoration.

From Lab - Surgical stent often made with a proposed access hole filled with gutta percha.

3
Surgery Appointment

Osteotomy using surgical stent for pilot hole

The stent is used as a surgical tool to give the surgeon a basic idea as to where the implant access hole should ideally be placed. Surgeon can take an x-ray to have a general idea as to the bone position relative to the guide hole due to the gutta percha radio opaque markers. Typically in a non-guided surgery the initial pilot hole uses the surgical stent, then the stent is discarded and the rest of the osteotomy is performed free-hand.

4
Placing of healing cap

The healing cap can be used to shape tissue creating the desired emergence and support papilla between the teeth and the implant restoration.

5
Implant level impression appointment

After healing and integration of the implant at the next step is an implant level impression. In most cases it is advisable to take an open tray impression.

Open Tray Procedure Presentation - Fig. 8

6
Restoration / Abutment(s)

From Lab - Restoration(s)

Single Implant Abutments - Digital Workflow

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1
Initial Impression Pre-Operative

Digital dental impression scanner - Burbank Dental Lab - California Dental Lab

2
Scanning Appliance

From Lab - Digital Wax-up

From Lab -Printing of CT Scanning appliance, with radio opaque teeth in the proposed implant position(s).

3
CT Scanning Appointment

Patient appointment for CBCT scan with scanning appliance.

4
Digital Surgery Planning

1. Merge CT scan (DICOM file - .dcm) with .stl of arch model

2. Plan surgery and design guide in planning software. Blue Sky Plan or Galileos Implant are two known software solutions that have the ability to export a .stl file for the completed guide, which is required to fabricate a surgical guide in an open system.