Grammetry Surgical Workflow Using Teeth as Reference

This video is going to show the process of keeping the teeth as the constant. However, this case has a little bit of a twist, and you’ll see what that is in just a second. Normally you would just capture
the upper, lower, and bite records pre-op, but this patient already has a couple of implants.

So you would capture the bite and then just move on and keep the teeth until the surgery is finished, but these teeth are in the way. So what do we do? As a reminder, once the teeth are gone you lose to bite. I know that’s kind of obvious, but what do you do when you’re going to put implants in some of these sites?

This doctor, Dr. Ford, was pretty creative and figured this one out. What he did was add OptiSplints to these anterior two, place the implants here in these two sites, placed an OptiSplint here,
and then scanned. Dr. Ford then use these two teeth as the bite, and because he scanned a lot of the land area, the tissue, and everything, we were able to use all the land areas to preserve the bite. We used these two teeth here, we used tissue and land areas, and put the bite back together. Then the doctor continued on with the surgery and finished placing the rest of the implants. Then the doctor attached to OptiSplint to the rest of the implants, luted them together, and then scanned the OptiSplint in the mouth.

Now, this could have been scanned intraorally or extraorally, but it’s probably a good idea, in this case, to scan it in the mouth first. That way we pick up the tissue again and make sure everything is aligned nicely. After the initial scan, the doctor scanned it extraorally to get a controlled scan of the OptiSplint all luted together. Since this was a same-day situation, we took the records back to the lab and started registering and stacking our files together, and based on this we designed the restoration.

Let me show you the tissue scan here quickly…So that is the prosthesis that we made, here is the intaglio…and overall it was really a smooth operation. I think it was very creative of the doctor to use the OptiSplints on one side and keep the teeth on the other where the implants were going to go, so nice job, a very nice result.