iCAM and Case Studies for Fixed Full-Arch

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The fifth and last method, which is bleeding edge, as they say, technology. I only say that because what we’re doing with it, I believe is bleeding edge. The PIC and the ICAM have been around for a number of years. We saw them in at IDS in Germany five years ago. They were around a little bit before that. Their technology is incredible for making a, for making a passive digital file. And the reason we held off on getting involved is because we found that their acquisition of multi-unit abutment or implant position is more accurate than the model we would print to reproduce it. And we didn’t trust a resin printed model to go to, you know, to make a restoration. So instead, we decided to stay fully digital, which is where NobelProcera Bridge came in when they, when they walked in our door months ago and put that coping free Procera bridge in our hands the light bulb went off.

You know, now we get involved with ICAM and maybe PIC some time, but right now ICAM and make a prosthetic simply from digital records, in my opinion, unattainable before, a hundred percent digital. So watch this cool process. This is Dr. Hanssen. He and I have worked together an awful lot in the past five months, completing several cases all from his digital records. Dr. Hanssen is great to talk to and great to troubleshoot problems with, but very good at what he does clinically with the records exceptional. And it made our job easier for really for RnDing, this process. So what he had, this is a, I’m gonna show two cases. So this case is, he had a patient come in today with a completely demolished upper temporary hybrid.

So patient already had, even though this doctor does surgery, he had a patient who already had a hybrid, needed a new one. So he uploaded the scans, he took the ICAM scans. You saw that with the dominoes. He takes DESS scan bodies, that’s a company DESS, they sell scan bodies that are specifically made for the ICAM registration. He scanned the prosthetic, he scanned the opposing and scan the bite, and he sent that to us. Here are the records. I’ll turn this down. It just makes that little beeping noise. That’s his registering. But the dominoes are in the mouth and the doctor takes his ICAM scan, he hovers it over the mouth, and he is capturing the positions of the four, in this case, four multi-unit abutment positions, i.e. Implant positions. And it takes, I think it’s a minute or two, you know, depending on how many implants there are there, these are really spread out through the mouth.

So it’s easy for the camera to capture ’em. But it registers one, you can see green, green, red, red. So he’ll keep going until they’re all green. And then once that’s finished, he’ll take those scan flags out, the dominoes. He’ll do another scan with these DESS analogs, and then he’ll seat the prosthetics and he’ll do intraoral scans of the prosthetics seated. Those are the scans. And then what we receive, you see on the left is we have tissue, we have scan bodies. We have a prosthetic seated that can be registered back to the original scan. And we have tissue. So we have intaglio. This is what it looks like in color. This is black and white. And what do we do with this? We bring this into our software. We have what the patient’s wearing. We have implant positions. I think I’ll turn on the little, yep, yep. So we have, those are not copings, those are screw channels. Those are just screw channels. This is a coping free tryin and a coping free NobelProcera Bridge.

Make a proposal right here. That’s what we’re proposing as a new final. We print it in, we printed it, we send that off to the doctor as a preview. And sometimes it’s just screenshots with the DTX software, Nobel software. And sometimes it’s a video plan for a prototype. Doctor signs off on it. We fabricate this. This is a printed tryin for trial, and we use these special screws and these screws contact the resin only, no copings. So now we’re really test driving the, the coping free prosthetic doctor will receive this. And then you can, you can see here, print tryin with pink went perfectly, no adjustment, order the Procera bridge. So he screwed this in. Now this is, we put pink on this ’cause we wanted the patient to wear this one home and be comfortable with it, screwed it in.

He had no adjustment, zero, and he did not have to send the prosthetic back. There’s no model, there’s nothing to articulate or ship, nothing. He just calls us and says, make a final. So with that we just simply uploaded our file to Nobel. They milled this bridge, we shipped it back to him, screwed it down, away the patient went. It was brilliant. And you can see his quote here, final zirconia seated with no adjustment. I can’t think of a better, more efficient way to do it. Now you have to buy a scanner. You have to buy an ICAM scan. We’re working with, we’re working on PIC. Maybe someday we’ll be compatible with PIC scanner. Right now it’s iCAM. It’s pretty affordable, I think, for what you get, especially if you have a lot of full, large cases in your practice that need turned over in the coming years.

Let’s look at one more. This is a dual arch. This one’s a little, this one’s pretty creative but maybe don’t focus on the complexity of the workup to get to scanning. But may maybe, you know, in other words, that’s gonna be kind of intimidating because what he did with this case was he sent us, these are just photographs on the left. He sent us a digital impression of the patient. So this was pre-surgical. And from this we did a diagnostic, a digital diagnostic workup, made a matrix. And from this, he went to surgery and it was a free hand surgery. And sent the patient home for just a few days over a weekend in this prosthetic. The bite was right on for him.

You had to do a little bit of a equilibration, but it’s based on the preoperative records. So he converted this, and on the day of surgery, he scanned it. So 96 hours later, we sent him a prosthetic. These are the files that he sends us on the day of surgery, though that same protocol we went through, just kinda like what I’ve been showing all along here. We make ’em a prototype. We email this over within 24 hours. There is the tissue and you know, this is, this is a temporary, we’re gonna go to a final down the road. It’s gonna be changes in the tissue. Yes. But we have the records here to make a Procera bridge. In the end, all the doctor has to do is scan the tissue, upload it to us, we bring it into the plan, and we order a bridge, coping free, model free, a hundred percent digital.

You cannot do that with any other zirconia. Not possible that I know of. You can chat in the end if you like, and we can talk about it. Or you can gimme a call. There’s some other option. We’ve been looking into this for a long time and Procera Bridge seems to be the only method of doing this that I’ve seen. You know, model free coping free, a hundred percent digital. Here’s the tryin patient, you know, patient went home in the other prosthetic, the not so hot prosthetic, but you know, had this by, I believe Tuesday after a Thursday surgery. Very efficient. Nice work.

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