triple scan protocol (dr. gross) - a new and effective protocol for 3d planning and guided surgery...
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triple scan protocol (Dr. Gross) - a new and effective protocol for 3D planning and guided surgery of partially edentulous cases Cortex guide - complete service for advanced 3D planning and guided surgery of dental implantsTRANSCRIPT
Triple scan technique (Dr. Gross)
A new and effective protocol for computer guided planning and flapless
implant placement for partial edentulous cases
Dr. Michael GrossImplantologist and international lecturer
Scientific consultant for dental implant industry
Lecture program
• Classic protocol : dual scan technique
• Guided surgery and immediate loading
• Simplified instrumentation for expanded indication
• Triple scan technique and case scenarios
• Clinical support and education
Lecture program
• Classic protocol : dual scan technique
• Guided surgery and immediate loading
• Simplified instrumentation for expanded indication
• Triple scan technique and case scenarios
• Clinical support and education
3D planning with visualization of radiographic denture
3D scan of radiographic denture alone and alignment on 3D scan of patient bone
3D Scan of patient bone wearing radiographic denture with x-ray markers
File transfer over internet of planning data
Precise 3D planning of position and angulation of implants and guide pins
3D relation between planned implant positions and radiographic denture
Fabrication of surgical guide converting radiographic denture
Radiographic markers in denture included with guttapercha or Cavit
Lecture program
• Classic protocol : dual scan technique
• Guided surgery and immediate loading
• Simplified instrumentation for expanded indication
• Triple scan technique and case scenarios
• Clinical support and education
Guided surgery and immediate loading
• Dual scan protocol was developed for edentulous cases with immediate loading
• Promoted for teeth-in-a-day with prefabricated restoration
• This requires implant placement over surgical guide and therefore titanium sleeves in surgical guide
• This requires development of guided surgery kit with many components – costs –
• If not all planned implants have required primary stability, prefabricated restoration is useless
Lecture program
• Classic protocol : dual scan technique
• Guided surgery and immediate loading
• Simplified instrumentation for expanded indication
• Triple scan technique and case scenarios
• Clinical support and education
Simplified instrumentation for expanded indication
• Reduced instrumentation for compatibility• Eliminating the need of implant specific surgical
guide kit – universal guidance of 2mm and 3 mm drill with depth stop
• Eliminating the need of titanium sleeves – use of titanium drill guide handle 2mm and 3mm which is introduced in surgical guide
• This expands indication because collision of titanium sleeves with close or inclinated implants is eliminated
• In extremely narrow situations use of 2mm guide sleeves for use with 2mm drills
Simplified instrumentation for expanded indication
• Reduced instrumentation for compatibility• Total inventory needed:
1.1 drill guide handle 2mm / 3mm
2.1 drill 2mm short with depth stop
3.1 drill 2mm long with depth stop
4.1 drill 3mm short with depth stop
5.1 drill 3mm long with depth stop
6.1 drill 1.6 mm for guide pin
7.3 guide pins (reusable)
Costs: total only 712 US$ + shipping
Lecture program
• Classic protocol : dual scan technique
• Guided surgery and immediate loading
• Simplified instrumentation for expanded indication
• Triple scan technique and case scenarios
• Clinical support and education
Triple scan technique
• Most of implant cases are partially edentulous
• Radiographic partial denture for dual scan has disadvantages– Fixation on residual teeth poor if not extended over
them
– Visibility of residual teeth compromised if covering them
– Gingival contour of neighboring teeth and edentulous areas can only be estimated as underside of denture
Triple scan technique
• Solution for partial edentulous cases
1. CT or CBCT scan of patient without any appliance in open occlusion
2. Optical scan of master cast (can be modified and imported at any time after CT or CBCT)
3. Optical scan of master cast with diagnostic wax-up (can be modified and imported at any time after CT or CBCT)
4. Alignment of both optical scans with 3D model of bone
Triple scan technique
• Solution for partial edentulous cases
1. Implants can be backward-planned on cast with diagnostic wax-up with visualization of available bone, excellent details of teeth and soft tissue
2. Relation of implant and soft tissue depth can be verified with visualization of master cast without wax-up, excellent details of teeth and soft tissue
3. Relation of implant to crestal bone can be verified with visualization of bone without cast
4. Fabrication of tooth-supported surgical guide over master cast without wax-up
Dual scan technique
• Indication for totally edentulous cases
Dual scan technique
• Indication for totally edentulous cases
Dual scan technique
• Indication for totally edentulous cases
Dual scan technique
• Indication for totally edentulous cases
Dual scan technique
• Indication for totally edentulous cases
Dual scan technique
• applied for partially edentulous cases
Dual scan technique
• applied for partially edentulous cases
Dual scan technique
• applied for partially edentulous cases
Dual scan technique
• applied for partially edentulous cases
Dual scan technique
• applied for partially edentulous cases
Dual scan technique
• applied for partially edentulous cases
Triple scan technique
• applied for partially edentulous cases
Triple scan technique
• applied for partially edentulous cases
Triple scan technique
• Implants planned on wax-up cast
Triple scan technique
• Implants relation to soft tissue
Triple scan technique
• Implants relation to bone
Triple scan technique
• Tooth-supported surgical guide
Triple scan technique
• Extraction case, modified cast
Triple scan technique
• Extraction case, modified cast
Triple scan technique
• Extraction case, modified cast
Triple scan technique
• Extraction case, angulation needed because of proximity canalis incisivus
Triple scan technique
• Extraction case, would be collision with master sleeves, no problem with drill guide handle
Triple scan technique
• Multiple changes on cast after CT scan, extractions and root canals done, planned extractions
Triple scan technique
• Multiple changes on cast after CT scan, extractions and root canals done, planned extractions
Triple scan technique
• Multiple changes on cast after CT scan, extractions and root canals done, planned extractions
Triple scan technique
• Multiple changes on cast after CT scan, extractions and root canals done, planned extractions
Triple scan technique
• Multiple changes on cast after CT scan, extractions and root canals done, planned extractions
2 mm guide multiple extraction case with tooth-supported guide over 3 teeth as strategic support
Lecture program
• Classic protocol : dual scan technique
• Guided surgery and immediate loading
• Simplified instrumentation for expanded indication
• Triple scan technique and case scenarios
• Clinical support and education
Clinical support
• CORTEX guide - Complete service for 3D planning and fabrication of surgical guides
• Provide surgical instruments at low-cost
• Online help with skype and teamviewer
• Simple data transfer over dropbox
• No physical shipping needed
• Free planning and viewing software Nemoscan
Clinical support
• CORTEX guide - Complete service for 3D planning and fabrication of surgical guides
• Turn-around time for guide fabrication 3-5 business days after final approval of planning
• Different shipment options
Clinical support
• CORTEX guide - Complete service for 3D planning and fabrication of surgical guides
• Costs for complete service per case (regardless number of implants):– One jaw, one guide: 500 US$ plus shipping– Both jaws, two guides: 650 US$ plus shipping
Tel.: +1-809-736-9040Cel.: +1-829-548-6135Santiago – Llanos de GuraboC./a Jacagua entrada km 7Res. La Senda, casa [email protected]
Contact:
Dr. Michael Gross
CORTEX guide
www.cortex.dominicanhealth.org