Grammetry Case Study: Single Arch Dentate with Teeth Reference

This Grammetry case was completed by Dr. Sully Sullivan, one of our first KOLs working with Grammetry. The patient photos are not of the same patient; we just put these in here as examples of photos that we want to see for a Grammetry case, which are full face, full smile, and an exaggerated smile just so we don’t have any surprises with transition lines. The image on the right is the pre-operative record. Now, this case is going to use teeth as the fiducial marker or the constant. These teeth are not going to be extracted, but rather we’re going to idealize the anterior position of these teeth. This will be a freehanded case, not guided.

Let’s go through the process. First, before surgery, take your iOS scanner and perform a scan of the upper, lower, and bite registration because this is tooth supported, so no surgical tads needed. Now, let’s jump forward a bit. The implants are in, and now the OptiSplint scan bodies are screwed down to each multi-unit abutment. The OptiSplints are positioned so that they’re touching, or just about touching; it’s not a requirement, but it certainly helps. Then the doctor will simply add some composite material down in the holes in the scan bodies. These are called the vertical arm, and each scan body also has a horizontal arm that stands upright. So fill these holes with some composite or with some Stellar material, preferably something with minimal material shrinkage. Fill them up like so, and then you’ll bring in the metal honeycomb frame that will be luted to all of the scan bodies. This is the beauty of Grammetry: you have the ability to lute them all together in the mouth as opposed to other techniques that we think are not quite as accurate. Lute them together, and then once they’re all together, hit them with a curing light if you have a light cure material, and this is what you get: a solid frame, just like a traditional fit verification jig.

It’s very easy to make, and now you have the best of both worlds, something that you can scan and something that you can remove. And if you want to make a model, simply attach copings to your restoration and send it to the lab for the final zirconia. There are some wonderful advantages to not being a 100% digital solution. Now, Grammetry IS 100% digital for the day of surgery, the printed prosthesis, and the final restoration. We have some other simple techniques to go to final, mostly digital, and someday it’ll be fully digital. So take out your intraoral scanner, preferably one of our approved intraoral scanners, and scan the full arch including the teeth as those are the references. Then scan the scan body, scan the frame, scan the luting material, and capture the full arch. Please be sure that you are using one of the ROE-approved scanners: these five scanners work very well; maybe a little bit of issue with the Itero around the tissue, so just turn off the AI.

The rest of them will work just fine in just about any condition. So once everything has been scanned, simply remove the OptiSplint jig, save it, and then upload your files. In this case, you’ll have the pre-op upper and lower and the full arch scan that you captured. Send those off to us at ROE Dental Laboratory through our website; there is a Grammetry page that asks you just a few questions, and then drag and drop your STL files into the uploader and we will assemble your files like so. Using these files, we will make you a prosthesis and send this to you for you to print in-office. Very, very simple, economical steps. That’s Grammetry.