What Day-of-Surgery Record Capture do you need for Grammetry?

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This video is going to discuss ROE’s barrier, breaking record taking Grammetry service. This particular video is gonna cover one of the modalities for day of surgery capture and transfer of records to the laboratory to ROE in order to design your prosthesis. And the focus is gonna be on the combi guide. CombiGuide is a guided surgery product that gives the practitioner the ability to pre-planned bone reduction levels, pre-planned implant positions and angles, and which componentry to order for the day of surgery. So, let’s get started with the process of how to, how to go through this full case. The records will be sent over to the laboratory weeks in advance, which would include a cone beam. Include STL files for the planning at least a full face, full smile picture. We would also like to have pictures in retracted showing occlusion.

And what we will do is we will pre-plan the case and we will ensure that there is enough, bone reduction for prosthetic space. We’ll have the implants already pre-planned, ready for the online meeting with angulations and positions taken into account. We’ll have a quick meeting, and then what we will do is design the osteotomy guide, the fixation base, and the pin guide for delivery. And on the day of surgery you’ll have this, this on hand. You’ll also have the opti splint kit. The kit will have all of these, uh, items in it, but the main ones that you’ll work with are the, the optisplint itself, the scan body, the frame, and then materials to lute them together and to seat them. This, in this case, we’re suggesting use stellar to loot the frame to the optisplint, and then a curing light.

Stellar is a dual cure material, so you’ll have these on hand and with combiguide, you’ll have already sent us the records, the pre-op records for the guided workup. But what we, these will not include the prerequisites as, as a normal grammetry case, is the breadcrumbs or tads, or screws to maintain the bite position before and after surgery. In this case, because it’s combiguide, you’ll use the fixation base as the constant before and after surgery. So in this case, what you’ll do is follow our combiguide procedure, which is seat the pin guide, and the fixation base. After the flap is already placed, the pin guide holds the fixation base in place. These are fixation screws that hold metal in place. And the pin guide the plastic is just simply a delivery device. And once the fixation base is seated, then you’ll see the tissue has already been reflected.

And at this point, you will scan the teeth and you’ll scan the fixation base. And at this point, we are leaving the occlusal, the facial and occlusal of the fixation base rough, so that it’s easy to scan. It’s not very shiny, and you’ll capture all of this. Now, if you have, if you struggle with capturing all this anatomy, that’s okay. We will take the preoperative scans and we will merge them using the teeth into the surgical scans. The most important part is that you capture the fixation base and at least a bite registration of the teeth in this case just the maxillary teeth, because we already have the bite in the opposing from the pre-op scans. Okay. Once this is captured, then proceed with the surgery, which is extract the teeth, reduce the bone, and then just, you know, just as a reminder, just like the screws or the arch tracers or any other breadcrumb that you leave, it’s the fixation base that remains constant, right?

Because on the right here, we’ve lost a teeth, lost a bone, the reference is gone, the reference is the, the metal. So then you will drill the osteotomies, place, the implants place the multi-unit abutments here, just kind of showing a visual representation of it. And at that point, once the multi-unit abutments are in, then you will seat all of the optisplint scan bodies. You will seat the frame and you will quickly lute it to the horizontal arms of the optisplints. And this should be a very quick process. You’ll just thumb tighten, you know, just hand tighten the optisplints onto the multi-units. And at that point, you will scan, you’ll scan this, which is scanning the metal, scanning the opti splint, and capturing all of this data. Okay? And at that point, you will upload the files to us, which is the preoperative, the surgical with the fixation base, the optisplint with the fixation base.

Those are the scans that you’ll upload to us along with the photos of the patient. We will design a prosthesis and return it to you ready to print. This was a case that Dr. Agarwal completed recently preoperative photos, which we like to have, just to confirm the bite. Getting ready for the, um, for the combiguide design and for the implant meeting. So doctor captured iOS impressions preoperatively. Okay. Then during surgery, doctor scanned the occlusal of the fixation base, scanned the teeth as well. He scanned this after a couple of extractions. Teeth had to come out because of the pin placement, but scan the teeth and then he teeth were removed, the bone was reduced. And then doctor captured all of the areas we discussed before, the optisplint. And the fixation base doctor uses a Primescan which is an excellent scanner for this type of scanning.

Really works great every single time. And this is what doctor uploaded, uploaded full face, full smile, preoperative photos, the STLs preoperative, and then the STLs of the fixation base, the optisplint and fixation base. And from this we designed the case of the design work. So we, because doctor took a, a really nice preoperative photo, we designed the prosthesis within the mouth, within the face behind the lips, making sure that everything was just, just right for the patient. So you can see here we have the preoperative and the I’m sorry, the teeth and the fixation base. Now we have the optisplint, which we merged together and the opposing. And then, based on these records, really straightforward, straightforward records we designed the prosthesis and we, sent it to the doctor to print and beautify chairside. Okay. And that is Grammetry CombiGuide process. And thank you very much, Dr. Agarwal, for sharing this case with us.


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Tags: Patient Records

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