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Why does ROE recommend photogrammetry or Grammetry records on GuidedSMILE revision cases?

This is the single biggest accuracy upgrade available on a revision case, and it is worth understanding why.

The problem with traditional records

In a traditional dual scan, the denture becomes the pin guide. The pin guide is therefore tissue supported, relying on the palate and the ridge, with perhaps some incidental contact on LOCATOR abutments. On an edentulous ridge, that guide will rotate and shift, and every downstream component inherits the error.

On a routine edentulous case that tolerance can be absorbed. On a revision case it cannot, because:

  • The real estate is extremely limited. New implants are being threaded between existing implants, often into the last remaining bone.
  • Fixation pins, existing implants, and new implants all compete for the same space.
  • Many revision plans include pterygoid implants, which demand precision.
  • Bone reduction is preplanned from the teeth down, so guide position drives the entire result.

The precision of the records dictates the precision of the surgery.

The precision ladder

Record method How implant position is captured Guide support Relative precision
Traditional dual scan Denture with radiopaque markers Tissue and palate supported Lowest
Dual scan plus 360 denture scan Denture scan yields a negative of the LOCATOR abutments Seats on LOCATOR abutment geometry Better
Dual scan plus IOS tissue and abutment scan Intraoral scan inverted and merged with the dual scan Improved intaglio accuracy Better
Conventional scan bodies on MUAs Scan bodies digitize multi-unit abutment positions Pin guide seats on the scan bodies High
Photogrammetry or Grammetry Photogrammetry system, or Grammetry OptiSplint / ArchBridge scan bodies Guide screws directly to the multi-unit abutments Highest

Practical notes

  • Roughly 15 photogrammetry systems are on the market and effectively all of them will work for this purpose. ROE supports iCAM, PIC, Shining3D Elite, Micron Mapper, Grammie, and other acquisition systems.
  • ROE's Grammetry system delivers comparable accuracy using the intraoral scanner you already own, without a capital investment in photogrammetry hardware. Both Grammetry OptiSplint and Grammetry ArchBridge are supported on the revision checklists.
  • ArchBridge scan bodies for LOCATOR abutments bring overdenture revision cases to the same level of digitization. They click onto the LOCATORs and the attachment position is captured precisely.
  • Healing collars are not required. Simply scan the tissue, the palate, and the scan bodies themselves.
  • Scan bodies are largely PEEK, so they leave the CBCT far cleaner and easier to stack than a zirconia or metal prosthesis.
  • The accuracy target here is a guided surgical result, not a metal-to-metal final restoration fit. Grammetry scan bodies comfortably meet that standard.

If you already work with a photogrammetry system, see ROE's dental photogrammetry services for design turnaround options.

 

Resources

    Contact Information

    For immediate chairside support or troubleshooting assistance, contact ROE Dental Laboratory: