What are the Photogrammetry Records for Surgical and Restorative Cases?

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Transcript

This webinar is going to discuss photogrammetry records. We’re gonna talk about the day of surgery process and the restorative. The day of surgery, dentate the day of surgery, surgical restorative for edentulous, which really the live surgery and restorative edentulous are pretty much the same. And then restorative dentate. Let’s start with a single dentate arch. And actually, this can be thought of as a single or a double. Most of these cases, many of these cases need to have the bite opened. So if you, if you know that the shimbashimeasurement or the patient is overclosed, really need to send us these preoperative iOS scans. Just these two right images. We’ll articulate, we’ll open the bite physically on an articulator. We’ll make one of our JC tryins, which is a hard, basically a hard bite opening device. Send it to you to print or physically send it to you.

And then you’ll open the patient’s bite, equilibrate, make sure this device fits. Send back an actual PVS impression with the physical JC tryin. We will articulate, open the bite and perform a setup to the new bite. So that’s for over closed situations. If we’re gonna go directly that day patient comes in, you’ve already pre-booked the surgery with us, then these are the records that you’re gonna capture. Pre-surgical, right? So you’ve put a tad in, you’ve taken an iOS scan of the arch or arches, you know, if this is a lower, you’re gonna put a tad back here in the retromolar pad area or perhaps in the labial, maybe in, maybe here on the lingual, depending on what works for you. I know that sometimes the tissue is hard to keep on the outside of these screws when it’s in the anterior and lower.

But you’ll take an iOS scan that captures a tad, and then you’ll close the patient into the bite. If it’s a JC tryin, fine. If it’s just natural teeth, the natural teeth, capture that and hold onto those files. You don’t need to upload ’em yet. Then you go through the surgery, and once the surgery is finished, then you’ll take another iOS scan. Now, this is going to capture the tad again, in the same spot. This should not have moved. If it came out, then we’re gonna have to use some other anatomical landmark. But that needs to be in there before the teeth come out and after the teeth come out, that is our reference for the bite. In this case, we could also use the molars that are still present. Okay? And so you’re gonna take an iOS of the scan bodies, the refs, and then you’re also gonna take the domino scan, right?

The photogrammetry scan. You’re gonna export those files, right, just as always. And then you’re going to upload them to our laboratory through the portal on our website. So these are all the records that you’re gonna upload at once. They can come in these three folders. We got the iMetric export or photogrammetry export, whether it’s PIC or not. You’re going to have a before and an after with a tad. You’re gonna have an opposing, and you’re gonna have a bite. If this is double arch, then there’s a tad on Tads on both arches. And just scan the arches and we’ll bring those into the software to marry with the pre-surgical bite. And then always take photographs. We want full face, full smile. And then we want an exaggerated smile. So we wanna make sure that we’re putting the next set of teeth in the right place.

So this is the package. You’ll put ’em all in this folder, separated by these names. Put the photos in there, zip this folder, and then you’ll go to our website and upload. The scan tads. The scan tads are the screws that go into the pallet or into the retromolar pad area, you know, are just, just depending. Sometimes it’s case by case. Sometimes it’s how the doctor is taught. Some doctors even take a PVS impression or an alginate impression during surgery, you know, before and after surgery, sorry. So one is before with the tad. One is after. With the tad, you really need to pour these up in stone and then scan the stone because an iOS scanner is gonna have a tough time getting inside of here. So if you’ve found success with scanning impressions, fine. But really the best thing is pour ’em up.

Otherwise, you’re just taking iOS in the mouth. So here’s two, right? And then there’s two here. We’ve seen a lot of ’em with just one scan, tad. We also see them with a printable resin material that is just disposable. So the screw goes to the resin and into the bone. That’s, that’s nice too. And of course these have to be in the mouth before and after extraction and surgery. Just putting it in before or just putting it in after does not work. These are the reference. Once the teeth are gone, teeth are gone. We use this to orient the mouth back to the bite. Alright, so that is dentate, single and double. Let’s go through a surgical or a restorative photogrammetry case. They’re, they’re kind of the same because you’re gonna use the same prosthesis if the patient doesn’t have teeth, you know or a prosthetic down the road.

So this is situation where the patient has upper and lower dentures, and we are going to convert them on the day of surgery into, basically into indexes. I think of what a denture gives you. It gives you the tissue or with a redline. It will, it gives you tooth position, it gives you a bite, it gives you vertical dimension. It gives us just about everything we need to know to make prosthetics. That means when you go through surgery you’re gonna follow some of the same principles. Now, if a patient is edentulous don’t need the tads because we’re gonna use the scan bodies as the reference. So that means that you can either do a single arch method one day, or you can do double arch does change the records a little bit. Let’s say you’re doing both in one day, you can remove the teeth, put the implants in, go to the other arch, or remove the teeth, put the implants in, and then you can basically wash impression the dentures to pick up the scants, just like that.

Put ’em in occlusion wash. This is all a reline in here, both arches, a reline impression. And then you’ll scan the prosthetic 360, scan the lower prosthesis 360. You’ll take the ICAM scan records and export or the photogrammetry records and export. And you’ll upload it. And so here, what, what are your records? Full phase, full smile. 360 iOS scans of the prostheses, bite registration, digital bite registration, and photogrammetry exports. That’s it. Those are the records. And from that, we will make STL files. So let’s, let’s just go through this all during that quickly here. And so this is the denture scan comes in. I’m gonna kind of go fast. You see how it was washed in the mouth to pick up the scan bodies? Okay? And then we bring this back in the laboratory. We have the opposing, okay, this is single arch. Identify the model, perform a setup. Obviously we’re going very fast through this. Make a setup and export the STL file.

Quite a simple process. Okay, so that was single edentulous, double edentulous. And happy to take more questions on that. And then finally, restorative, right? The first two were surgical, and this one is more restorative, just like the second really the edentulous parts restorative. So this means a patient has had their surgery, they have a prosthesis that is screwed down, and they have opposing a bite. They have everything they need to send us records for the final. So what you’ll, what you’ll do is take the prosthesis out of the mouth and you’ll scan it. 360, hold it in your fingers, scan it, okay? 360, every little bit of it until it looks good. If you’re holding it here with your fingers, then get to that point. Switch your fingers over here and scan the rest of it. Alright, the next one is, while the prosthesis is out of the mouth scan the tissue with the scan references, right?

The scan body, you can use Nobel healing caps. You can use PIC or ICAM scan references and save that. And then you’ll scan the scan flags. You know, you could use the same scan flags from surgery if, if you have those from surgery. But things change. So I’d probably just go ahead and take a new scan, flag domino’s scan, and then seat the prosthesis in the mouth and scan the bite. Scan as much of the bite as you can. Get a really nice scan of this patient. Just has a little bit of contact here and a little bit of contact here. I don’t know anything about this case but that’s okay. Capture the bite, capture some of the tissue. There’s your bite scan. And then, and then of course export, you should export the ICAM files or the PIC files.

And this is what you upload. So this, in a folder. A folder has the healing collar scan. It has the iMetric export. It has the temporary 360 scan. It has the temporary scan in the bite position. And then of course, always a full face, full smile photo and an exaggerated smile. Put all those in a folder. You can combine the STLs into one folder, that’s fine. And zip them and then upload ’em onto our website. All right, so that is a restorative single arch case. And from this we’ll make a prototype, either fabricated the laboratory or send the file. If this was a double arch, then you would just repeat these two. Scan the upper, scan the lower scan the mouth with a scan flag. Scan flag. Uh, dominoes both arches.

Screw them both back in the mouth and take the bite. And then two exports, maxilla and mandible. Just double. Now let’s go to the restorative phase to order final prosthetics. Because remember this what we just showed can be just for a prototype, which is really the same files. I mean, I’m just kind of scrolling down through the, through the, the slides here. But essentially the same thing to go to final. So let’s say this is refined, this is a nice looking prosthesis. And you wanna just copy it and go to final, follow these same scans. If we already have the export of the photogrammetry or PIC files, send those along with it. Just send the prosthesis file. And if you’ve made any occlusal adjustments to the prosthesis, right, any occlusal adjustments, then screw this back in the mouth and scan the bite, okay? And that way we can make sure we get the bite correct. And these will be your uploads to go to final.

Alright? So with those files, you have three options. Well probably have more, but you have three options. We can just make you a monochromatic prosthesis, which you can print, or we can print just for a looksie. We can make a prototype with pink to make it beautiful. The patient can wear at home, work out the occlusion. And of course, we can go straight to final. All from the ICAM records, no copings with milled zirconia, direct to MUA. And then we can use these screws. These screws are gonna be for the prototypes. DESS, Powerball, Dan Roses. And those are just for prototypes to go to final. We provide a zirconia bridge, but you’ll use more conventional screws. Like if this is, this is a procera Nobel final prosthesis. You will use the Procera final parts. Either they’re direct to multi-unit screw, which is a, like a conventional screw that you’ve always used a prosthetic screw. Or if it’s direct to implant, then they have a little gold piece that goes into the prosthesis. It kind of snap fits in here. And then they use a longer screw. It’s actually a angled screw channel screw. A little different With that, thank you very much for watching our informational video on photogrammetry records.

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