Digital Dentistry Clinical Applications Flashcards
what is the rationale for digital dentistry
- adaptation and material properties -> better treatment and prognosis
- esthetic outcomes
- improved process for operator/dentist -> better outcomes
- improved experience for patients -> better outcomes
with digital dentistry there are improvements in:
- adaptation of the prosthesis
- retention of the prosthesis
- material properties
- esthetic outcomes
- improved process for operator/dentist
- improved experience for patients
describe the adaptation of the prosthesis
- dimensional accuracy
- setting expansion of dental stone
- polymerization shrinkage
- pack and press
- fluid resin
- injection
- milled
milled denture bases are _______ retentive as compared to heat polymerized denture bases
significantly more retentive
what are the material properties
- strength
- density
describe the strength
- flexural strength - 3 point bend test (MPa)
- milled resin > 3-D printed resin > or equal to heat processed resin
what does increased density result in
decreased candida adherence and reduced residual monomer
what are the esthetic outcomes
- tooth arrangement (Mould, size)
- color: hue, value, chroma
- texture
- ivotion denture system
- tooth shades BL3, B1, A1, A2, A3, A3.5
- multiple digital tooth libraries
what are the improved process for operator/dentist and patients
- workflow
- fewer clinical appointments
- less chair time
what is the digital denture workflow
- 1st appt: preliminary impression: student fabricates custom tray with attached occlusion rim
- 2nd appt: secondary impression and jaw relations: QA step, review/approve digital design, request 3D printed trial denture
- 3rd appt: clinical trial appointment: request milling of digital prosthesis. student required to participate in scanning, design and printing
- 4th appt: clinical insertion of prosthesis. student required to participate in the milling
what happens at the first clinical appointment
- student makes preliminary impressions
- on the preliminary cast: student makes a well- fitted custom tray with a wax rim attachedw
what happens at the 2nd clinical appointment
- secondary impression and jaw relations
- need to identify/mark: midline, incisal plane, CR record at OVD, tooth moulds and shade
what design software is used
3Shape software
what printer do we have in house
3D NextDent 5000 printer
what happens at the third clinical appointment
clinical trial
what parameters are there to evaluate at the 3rd clinical appointment
- fit of the base/intaglio surface and border extension
- CR-CO
- OVD: to evaluate phonetics, physiologic rest position, facial measurements and tactile sense, swallowing
- lip support: evaluate borders of the base, position of anterior teeth
- incisal plane (parallel to interpupillary line)
- midline
- tooth moulds
- position of maxillary anterior teeth: evaluate phonetics, esthetics, inclinations and relation to incisive papilla
- buccal corridor
- occlusal plane
how should the anterior teeth be inclined
labially inclined
- central incisor greatest labial inclination to the sagittal plane (28 degrees)
the printed resin trial dentures can be modified by:
- adding material: composite resin
- removing material: using a slow speed handpiece
what in house milling device do we have
- Ivoclar PM7
the insertion appointment is the process of ______
eliminating errors
what should not be adjusted at insertion of digital dentures
- no adjustments needed on intaglio
- no occlusal adjustments needed
what are the challenges
- pre- op scan
- scan body
- emergency profile scan
