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Inside Dentistry
July 2018
Volume 14, Issue 7

A Transformative Idea Becomes Reality

Tahmasebi uses the FirstFit guided prosthetics delivery system to prepare and seat in a single visit

The process has always been the same: prepare the teeth, take an impression, and design the restorations based on the impression. Of course, there are some variations in how each of those steps is executed, but the general process of crown-and-bridge dentistry has been a constant.

Cyrus Tahmasebi, DDS, FACD, sought to change that. While heading the research and development team for a major manufacturer approximately 10 years ago, Tahmasebi identified a problem with subpar margins on many dentists' preparations for veneers, crowns, bridges, and other restorations.

"I envisioned utilizing today's technology to 3D print guides to help dentists achieve better margins on their preparations," Tahmasebi says. "That would be helpful to everyone. That was where the idea started."

After 10 years of extensive development, the genesis of that idea is FirstFit-an innovative guided prosthetics delivery system that helps dentists prepare and seat a crown, bridge, or veneers without the need for temporaries, eliminating the preparation appointment entirely and delivering the most advanced, minimally invasive preparations available for patients.

Essentially, the FirstFit guided system involves taking the impression first and then using it to simultaneously print preparation guides and mill the final restoration.

"The 3D printed guides enable the dentist to precisely prepare the teeth and mill (ie, 5-axis ) the final restoration at the same time," Tahmasebi says. "In one sitting, the dentist can precisely and minimally prepare teeth and immediately fit the final restoration onto them. This saves the patient from additional chair time and the inconvenience of temporaries. It makes the entire process more accurate and convenient for both the dentist and the patient."

For bridges, FirstFit allows dentists to manage difficult situations with only two minimal preparations. Tahmasebi notes that not all patients are candidates for implants and that until recently, there were not many options for bridges.

"With this technology, first-time users have been able to prepare two teeth and deliver a three-unit bridge within 18 minutes," he says. "That completely changes the way that bridges will be done in the future."

Applying the precision of CAD/CAM to the preparations can offer esthetic benefits as well, particularly for veneers.

"We can digitally design the minimal preparation of the teeth to create proper cosmetic alignment for the patient," Tahmasebi says. "We can precisely predict how we will reshape the teeth, and we can share the digital preview of both that preparation and the design of the veneers with the patient before we even touch the teeth. That is a major development in our profession. The days of dentists just picking up handpieces and randomly reducing healthy tooth structure are coming to an end."

Early feedback has been extremely positive. Dentists arrive at FirstFit certification courses with skepticism, Tahmasebi says, but their reviews after the courses include evaluations such as "amazing," "a game-changer," and "I cannot do without it now."

Ross Nash, DDS, FAACD, was among the first dentists to use the system and had high praise for it.

"First Fit was easier to use than I expected, and I was surprised by its accuracy," Nash says. "The 3D printed guides allow for a very precise and predictable preparation that is digitally designed. This promotes a minimally invasive approach to treating teeth. It is fast, convenient, and eliminates the need for temporaries. Every patient loves a less invasive and more efficient procedure."

For Tahmasebi, the rave reviews are validation for the years of hard work.

"It was a labor of love, for sure," he says. "It has been a tough road to get to this point, but now it is definitely starting to pay off as I see the reactions of the dentists using it." The certification course includes CE credits, a starter kit, and the unique FirstFit handpiece, which is the key to engaging the guides and preparing the teeth.

"Having been an early adopter of technology myself, I have made major investments in lasers and CAD/CAM systems; sometimes they pay off, and sometimes they do not," Tahmasebi says. "The beauty of the FirstFit guided system is that it does not require a major investment up front. Essentially, the risk to learn about and try it is minimal, and the potential upside is that it can change the way that dentists practice."

"Digital dentistry is here to stay, and when patients find out
that there is a faster, less invasive, and more convenient way to
prepare their teeth, that is what they will demand," Nash says. "I believe this technology will have a tremendous impact on the future of our industry."

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