There are many approaches to restoring a full arch, be it through an analogue workflow or a fully digital workflow. As a dental technician, incorporating the Medit T500 into the anaCAM® workflow helped me in simplifying the process.
Handmade Skills and Digital Technology in Harmony
The ability to process my frameworks digitally has allowed me to work smarter, faster and get more predictable results than before. Dipping my toe into digital dentistry for all the right reasons with the purchase of my Medit T500 lab scanner opened the door to a multitude of full arch framework material options.
The Medit T500 lab scanner has completely changed the process for my workflow and although the deed of investing, casting and pressing continue to exist in my workflows, the ability to send an STL file of my handmade frames for CAM saves me time, as well as gives me more predictable results when working with certain materials.
Cheaper, Faster, Better
Being a high-end low volume laboratory allows me to work in a way that suits me, using tried-and-tested handmade skills and techniques all self-taught over the past three decades working as a dental technician. Digital dentistry for me is a tool, another piece of equipment that has taken on some of the more laborious tasks in the lab.
Maintaining full control of my designs was key while finding the right scanner for the job came next. The fact that the Medit T500 came with the pre-installed software colLab meant that I did not have to purchase an expensive add-on design software. The T500 also has a module for duplicating dentures, the “Replica Denture Module”, which made the choice of my scanner an easy one. The accuracy of the scanner is unbelievable!
The anaCAM® workflow begins at the second stage, with the supply of verification jigs, custom pick up tray and the clip-in clip-out tripodised bite rim. Then, working from the master model, the physical try-in is sent out to surgery. Once the try-in is verified by the patient and dentist, the information is captured in a set of matrices which capture information from the surgery, such as vertical height, tooth position, as well as any occlusal adjustments made.
Each individual denture tooth is then internally hand-prepped and a framework is reverse engineered from the tooth to the implant fixture. The idealised prep and frame for the patients’ restoration is the result, which in turn makes the design as cleansable and clinical as can be achieved.
Once the prototype framework has been finalised by hand, we can move on to creating a digital STL file of the framework.
Individually Supported Shock-Absorbing Polymer Teeth
Using the pre-installed software in Replica Denture Module, the Medit T500 scans the framework as a perfect copy with every tiny detail of the handmade and bespoke design of the framework captured.
The T500 scans the top and bottom of the wax up and meshes the two together to give you a perfect STL file of your wax up, with the whole process taking around 6 minutes. It is this digital process that saves me time when compared to the analogue routes of investing the framework wax up, burning out and pressing or casting. The file is then sent off to be printed.
Back in the lab, the framework is bonded on to the implant abutments inside a verticulator which ensures accurate positioning. The individual polymer denture teeth are then too, bonded on to the framework using the verticulator to ensure that each tooth is in the correct exact position in line with the verified try-in.
Next comes the gingival composite using a composite kit. The CoCr is surface-treated to get the perfect surface to bond to while the preopaque and opaque ensure that the gingival composite is retained to the framework for life. The final surface is then glazed which gives an impervious surface finish.
And that's the whole workflow!
Lee Mullins RDT is a dental technician with 30 years of experience. He owns a laboratory in Leeds, UK and specializes in the full arch implant hybrid. You can find out more and check out Lee's work at leemullinsrdt.com.