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    How to create a better, permanent smile

    How one technician used his inLab system (Dentsply Sirona) to make a digital solution from analog dental information.

    This was a case that I worked on for a very special patient—my own sister. The patient had a complicated dental history and has worn a removable denture for a very long time. Thankfully, she has a dental professional in the family and came to learn that she now had options for a more stable, permanent and beautiful smile.

    The patient no longer wanted the partial denture that she had basically learned to live with for many years; she wanted a “fixed” solution. Teeth #s 3, 4, 8, 9 and 13 were to be prepped and were our only abutments. (Figs. 1 & 2)

    Fig. 1Fig. 2

    Fig. 1                                                                                               Fig. 2

    My initial thought was to fabricate two bridges but I did not trust so few abutments and the multiple pontic spans. The doctor and I decided that a round house bridge (full upper restoration) was our best plan for success.
    It’s important to note that my referring doctor is not a CEREC® doctor nor a digital doctor in any sense, as I’m sure many of us still have quite a few of these traditional clients. I am, though, indeed an inLab®-using laboratory and all of my restorative solutions are produced using the latest laboratory equipment from Dentsply Sirona.

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    Step-by-step case

    The doctor sent us a physical pre-op model with an opposing model and the bite registration so we could create a full temporary for the patient to wear while her new smile was being prepared. After doing the model work, the maxillary model was prepped here at the lab. The case was mounted and then scanned with the inEos® X5. Using inLab SW (software) 16, we designed the temporary free-hand with no wax up for a bio-copy, and then milled the temporary out of a multi-layered PMMA puck. The patient was then able to test drive her new smile for a couple weeks. (Fig. 3)

    Fig. 3Fig. 4

    Fig. 3                                                                                                    Fig. 4

    The only change that we gathered was needed from the patient was to shorten the front four restorations about 1 mm. (Fig. 4) We later received the final traditional impressions along with a face-bow. We did the model work and articulated on the Hanau articulator Face-Bow system. (Fig. 5)

    Fig. 5Fig. 6

    Fig. 5                                                                                                  Fig. 6

    We then milled a second temporary with the necessary adjustments to use as biocopy in the inLab SW (Fig. 6). The case was set-up in the administration function (Fig. 7) and was scanned into the SW using the inEos X5 (Figs. 8 & 9).

    Fig. 7Fig. 8

                                      Fig. 7                                                                                  Fig. 8

    We finished scanning the upper, lower, buccal bite and bio-copy (Fig. 10) and the bio-copy stitched extremely well (Fig. 11).

    Fig. 9Fig. 10

                                                               Fig. 9                                                                                     Fig. 10

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