![]() Later, I was using the radiopaque PVS as a fiduciary marker to simplify alignment of two scans using principles of that protocol. I was just scanning the tissue surface of the relined denture and CBCT scanning the relined denture as I was instructed to do so at the time by others who developed the dual-scan protocol. Click here to view an article I recently wrote about using the technique with 3Shape Implant Studio software! Initially, the relined PVS would serve as a way of skipping having to make a PVS impression inside of the mouth with a stock tray. I pioneered a technique using radiopaque PVS material relined in the patient’s existing denture and scan it using CBCT or intraoral scanning. I had the need to treat a lot of edentulous patients with implant treatment and to utilize surgical guides in creative ways. One of my early articles describing this technique is posted in this article published in the Journal of Prosthetic Dentistry, check it out! In fact, many other clinicians begin their digital dentistry journeys with dental implantology in mind!Įarly 360 Degree Scan of Relined Mandibular Prostheses Using 3M TrueDefinition Scanner Intaglio Surface (left) Cameo Surface (right) I didn’t start out with digital dentures techniques just to make printed or milled digital dentures… I inadvertently and interestingly began evaluating certain techniques in surgical guide planning for edentulous implant overdenture cases. Many of these challenges I have fought over the years in development of my understanding and it’s been a progressive development of the technique I will describe in this article. Once we get past the actual scan and it works, how do we establish the OVD/VDO, the centric, the tooth position? Additionally, intraoral scans result in impressions like what you would get from a stock tray and alginate, over-extended and lack of established borders. No method works 100% of the time in 100% of patients but I believe we as clinicians are hoping for at least 90% of the time a certain method will work. When it comes down to it, predictability is key in a clinical practice or dental laboratory, we need to know that when we utilize a certain technique, material, system that it will work in the vast majority of cases. I have found the primary factors related to difficulty scanning edentulous arches has to do with the following clinical situations: 1) excessively flabby/movable ridges, 2) limited alveolar support, 3) reduced vestibular area, 4) operator difficulty controlling the floor of the mouth and cheeks, 5) operator experience with scanning, 6) patient factors – can the patient hold still and are they amenable to having a scanner wand in their mouth? With the right training and education, those limitations can be overcome but it’s not as predictable as a physiologically derived border molded impression to ensure the final denture has adequate retention and stability. Scanning teeth is easy, scanning edentulous ridges is a fairly advanced procedure. The biggest challenge is, while that intraoral scanning of edentulous arches is possible, it can be quite challenging and unpredictable for many clinicians/technicians. There’s a lot of excitement out there about direct imaging of edentulous patients using intraoral scanning, much of the excitement is for good reasons! Intraoral scanning of edentuous ridges is the closest we can get to for truly mucostatic impressions and is really cool for both patient and clinician/technician.Įdentulous Scan Generated with 3Shape TRIOS Intraoral Scanner Maxillary (left) Mandibular (right).
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