Tuesday, September 4, 2018

How iTero Saved the Day

Max iTero Model.JPG
There is an cover story coming soon to Dental Products Report about digital impressions and whether they are ready for prime time.  It’s written by my good friend Terri Lively and does a great job of covering the subject.  It’s not out yet, but should be available soon.  Be sure to look for it and check it out when it’s printed.
In Terri’s article she had me describe a case that I completed recently and I thought I’d share the image and the story here.
The photo above is a maxillary model that was created from a full arch scan with our iTero Elements scanner.  This case was a great one for digital because the patient had a very severe gag reflex.  We had tried to take a traditional impression, but due to the gag reflex present, that just was not possible for this case.  Instead, the full arch scan was taken.  The case was designed with a palatal strap  to decrease palatal coverage (you can see the design lightly scribed on the model).
Both arches were scanned and articulated.  The framework try-in with wax blocks went uneventfully and the wax try-in demonstrated the occlusion to be spot-on.
My only concern with the case being done with digital scans was the possibility of discrepancies with the tissue surface in the edentulous area.  I always try and design my cases (any type of case) with a Plan B in case our original solution does not work as originally designed.  My solution for this case would have been to take a functional impression of the saddle area and then have a hard reline done if necessary.  The amount of impression material needed would have been minimal and I feel it would have been tolerated well by the patient.
However, it turned out that I could leave Plan B on the workbench as the final tissue check was exactly what I had hoped it would be.
More and more the profession is moving away from analog impression systems.  The digital systems obviously require a “front end” investment, but as far as being “expensive”, in the analysis that we’ve done in my practice, it’s a wash.  This is a great example of creating a case that I would have perhaps been unable to do without the help of digital.

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