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Digital Impressions of Coded Implant Abutments
Merging technologies can improve patient experiences, and save time and money.
Computer-aided design and computer-aided manufacturing (CAD/CAM) technologies were first introduced to dentistry 40 years ago. Since then, these technologies have transformed many aspects of the way dentistry is practiced. It is now possible to mill crowns and deliver them to the patient in the dental practice without any involvement from a dental laboratory. For more than a dozen years, CAD/CAM technology also has been used to fabricate implant abutments. Like cast custom abutments, customized abutments fabricated with CAD/CAM technology can improve patients’ esthetic results by providing better peri-implant soft-tissue support.
The most recent breakthrough in the application of CAD/CAM to dentistry merges two distinct technologies. The first is digital intraoral scanning. The second is coded implant healing abutments.
Commercially available intraoral scanning systems have served as an alternative to conventional elastomeric impressions for several years now. While requiring an initial investment of money and time (to learn how to use them), they eliminate the need to purchase impression material and trays, mix and clean up the mess of conventional impression material, disinfect the impressions, and store casts long-term. In addition, patients tend to prefer the digital impression-taking experience.
Until now, digital sensor technology has not been used for making impressions of dental implants. But in March 2011, the US Food and Drug Administration gave 510(K) Approval for the use of the Lava™ Chairside Oral Scanner C.O.S. (3M ESPE, www.3mespe.com) and iTero™ (Cadent, www.cadentinc.com) systems to be used for capturing digital impressions of coded implant heating abutments (Figure 1). Such abutments, first introduced in 2004 (BellaTek™ Encode® Healing Abutments, BIOMET 3i, www.biomet3i.com), eliminate the need for impression copings. Instead, various arrangements of facets on the occlusal surfaces of the abutments identify the implant platform diameter, the healing abutment height, the hex position of the implant, and the diameter of the emergence profile, so that a supragingival impression can be made (Bellatek™ Encode® Impression System).
Combining the digital intraoral sensor technology with coded implant abutments offers game-changing benefits to both clinicians and patients. Patients are spared the need for any contact with messy impression material. Those with strong gag reflexes may particularly benefit from the digital technology, because the scanners do not touch the soft palate, are used for a briefer interval than impression trays, and allow patients to take a break, if necessary. Most scanners are comparable in size to other common devices such as curing lights and electric handpieces.
Furthermore, the restorative dental team no longer needs to select a tray, dispense impression material, allow time for material setting, disinfect the impression, package it up, and ship it to the laboratory. In the laboratory, there is no need to fabricate a master cast (plaster pour, base and pin, die cut, trim, and articulate), as these steps are eliminated. Instead, digital data from the digital impressions are sent electronically for virtual designing and milling of patient-specific implant abutments and (BellaTek™ Abutments and Copings).
Additional Time Savings
By sending the abutment design simultaneously to the BellaTek™ Production Center (BIOMET 3i) for milling of the abutment(s) and to a separate facility for fabrication of a rapid prototype model of the abutment(s) in the arch (Figure 2), even more time can be saved. The rapid prototype model can be sent to the dental laboratory for use in fabricating the definitive restoration at the same time that the definitive abutment or abutments are being milled. Alternatively, with some systems, CAD/CAM copings and crown fabrication can be done directly from the CAD design of the BellaTek™ Abutment. The abutments are patient-specific (Figure 3).
But there are intangible benefits too that, while more difficult to quantify in terms of dollars and cents, nonetheless have great value. Having a digital impression taken of their implant abutment or abutments becomes an interactive, 3D experience for patients.
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The preceding material was provided by the manufacturer. The statements and opinions contained therein are solely those of the manufacturer and not of the editors, publisher, or the Editorial Board of Inside Dentistry.