Case Planning for Ivotion Digital Implant-Supported OverDentureMay 20, 2022 by AACD Executive Office
By Robert Kreyer CDT, Director of Removable Prosthodontic Platforms, MicroDental Laboratories
Technical treatment planning is a preliminary procedure that demands clinical and technical communication and collaboration. This collaborative analysis of the acquired Intra-oral scan data of terminal dentition and soft tissue anatomy is critical to achieving a successful prosthetic outcome. Complete digital denture prosthetics should be treatment-planned and designed to replace lost bone, tissue, and dentition while restoring function, aesthetics, and phonetics. Establishing a definitive digital technical treatment plan with case sequencing procedures and appointments creates predictable success with complete prosthetics.
Prosthetic Design Solutions:
The Intra-Oral Scans are received then data is analyzed for the following:
The Prosthetic space analysis evaluates the Vertical Dimension of Occlusion, or intra-residual space, to provide adequate space for the definitive digital prosthesis. When re-establishing the VDO or prosthetic space, increase the intra-residual ridge space to allow for the design of the acrylic-resin base, implant bar, and denture teeth. According to the intra-vestibular measurement of scans, increase the 28.49 mm bite scan to at least 40mm. In design, a requested increase of 12.50 mm, will provide a 41 mm intra-vestibular ridge relationship.
In design, build model bases (maxillary gold and mandibular silver) to Intra-Oral Scan STL files (green).To ensure proper registration between the base and scan, the speckled areas are visible on residual ridges illustrating a good match between data in the scan and base.
The terminal dentition is virtually extracted with a 4mm anterior and 3mm posterior tissue and bone reduction to create prosthetic space within the intra-residual ridge relationship. For implant-supported prosthetics case planning, factor a 15mm per arch from ridge crest to incisal edge into the design.
The denture tooth mold is selected then teeth are arranged using terminal dentition (green) and anatomical soft tissue landmarks as a reference or guide for placement of prosthetic tooth arrangement.
Looking at the maxillary arch from the occlusal perspective, the denture tooth (white) position can be evaluated in relation to the residual ridge and terminal dentition reference (green). Note the relationship of canine to clinical crown and roots providing symmetry in design for an esthetic and functional arrangement.
The mandibular arch from an occlusal perspective shows the relationship of posterior denture teeth (white) to the residual ridge crest and terminal dentition reference (green). The middle is maintained and used for maxillary arch anterior tooth arrangement.
Denture bases are built-in designs with proper gingival contours for margins, interdental papillae, festooning, and border extensions.
For more information on this unique digital workflow, contact customer service at MicroDental Laboratories.
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