Intraoral Impression Scanning Combines Digital and Implant Dentistry for Streamlined Results

By Bart W. Silverman, D.M.D., Oral and Maxillofacial Surgery

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Case Overview
A 55-year-old male presented to my office with a right maxillary alveolar abscess and bone loss associated with his maxillary right second premolar. The patient had visited his dentist approximately one month prior, as his crown had fallen out. The dentist replaced the crown and the infection became apparent soon after. After consulting with the general dentist regarding tooth removal, a bone graft and implant placement with future internal lift were planned.

Treatment Plan
The fractured maxillary right second premolar was surgically removed, and a mineralized cortical bone graft as well as a cytoplast membrane was placed. Following healing, a CS 9300 CBCT scan was performed to take a cursory panorex. A Thommen 4.5mm/3.2mm x 9.5mm contact implant was placed, along with an internal sinus lift.

After healing, the patient presented to my office for a digital impression. A preliminary scan of the gingival former using the CS 3500 intraoral scanner was performed. The gingival former was removed, a scanning body was placed into the implant and the CS 3500 was used to scan the scanning body as well as the rest of the maxillary arch and the opposing arch. The digital file was sent to Core 3-D lab and a custom titanium abutment was fabricated. The abutment was shipped to Digident Dental Lab in Orangeburg, NY and a ceramic crown was fabricated after the general dentist picked a shade. The abutment was placed, torqued to 32 cm and the crown cemented.

This case illustrates how digital dentistry can be used with implant dentistry. Frequently, a fixture level impression is taken and subsequently a model is poured up in stone; on top of which a custom abutment is made. Later the dental technician will fabricate a ceramic crown. Using the CS 3500 intraoral digital impression, the workflow is streamlined. By placing a scanning body and scanning it with the CS 3500, the custom abutment and crown are produced via a digital model. The abutment and crown are planned virtually, reducing patient chairtime and overall case turnaround time.

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