Streamlining the Implant Workflow

By Alan Jurim, DDS

Today’s Tools Offer Greater Accuracy And A Better Patient Experience

We try to obtain the “big picture” for every patient when they first join the practice. We take a 3Shape TRIOS intraoral scan for all new patients. That digital information is saved in their record, and we’ll use it later for virtual treatment planning. The more we can identify and work up on a case before we treat a patient is going to help predict the outcome. It helps the workflow to identify and know what we’re going to need. If we’re going to need any special components or the site needs more preparation (bone grafting or other augmentation), we know that before the time of surgery.

We produce surgical guides using Implant Studio from 3Shape for implant planning, and print them on a 3D printer. The 3D software program also allows us to virtually perform the surgery and the prosthetic rehabilitation ahead of time, which is better for the patient because we can identify workflow issues prior to the patient ever being touched. We know what type of final restorations we should be able to make. We also save time by eliminating the impression appointment, as implant position can be picked up at the time of surgery using scan flags. We can make sure we are not just in the best surgical position, but in a position that is safe for the patient when we place the implants.

We combine the intraoral scan with the 3D X-ray, whether it was taken in our office or elsewhere, to produce surgical guides. We also use the intraoral scan to get a better idea what shades to use, and any other information for the case, such as the occlusion, and to show existing teeth, if any, to use as reference points.

We have been printing in our lab for about 4 years using several 3D printers. These allow us to take something digital on the screen and reproduce it. So if it’s a study model, a working model, or a try-in restoration, there are a lot of advantages with 3D printing in the digital realm. We print in 3 materials: stone replica material, a biocompatible material that can be used in the mouth (such as surgical guides), and soft tissue, which is important for printing implant digital models.

Patient Benefits For the patient, the experience is important because he or she gets to see the intraoral scanning process, and doesn’t need to have impressions made. Essentially, if you begin with a more accurate representation of the mouth, you end up with a more accurate surgical guide and final restoration. The patient also has a certain level of comfort knowing that they’re in an office that uses the latest technology.

Ultimately, the tools that are given to us with digital dentistry allow us to do things that we couldn’t do in the past. Those tools, if used properly and comprehensively, give us tremendous insight into knowing where we’re going before we attempt to get there.

As originally published in Dental Learning.

About the Author: Prior to graduating from New York University’s College of Dentistry and North Shore University Hospital’s general practice residency, Dr. Jurim received his dual degree in Computer Systems Engineering and Electrical Engineering from Rensselaer Polytechnic Institute. He is a co-founder of Jurim Dental Academy in Woodbury, NY, and a member of the American Dental Association, the American Academy of Cosmetic Dentistry, and the American Society for Dental Aesthetics. He is an active lecturer teaching dental professionals digital photography, digital dentistry and CAD/CAM technologies, and cosmetic case planning. He is a key opinion leader for Henry Schein Dental, an advisory board member for 3Shape, and the Director of Digital Dentistry at Touro College.