A little Wish List…

November 3, 2009

Yesterday I posted an article on the 3Shape D700 scanner’s ability to design custom abutments and the final restoration – all from one scan.  I showed a brief summary of the steps involved in creating a zirconia abutment and a full contour resin pattern that could then be pressed in Ivoclar’s lithium disilicate, e.Max.

I wanted to elaborate a little on other types of restorative options that can be designed using roughly the same methodology.

First, the abutment design can be milled in either titanium or zirconia.  If one were to choose a titanium abutment for a posterior implant where esthetics may be not as important, it would be  simple to follow the exact same steps as described in the previous post.  The resulting full contour pattern could then be cast in the alloy of your choice.  Or, if current cost of gold has you wishing for alternatives, the full contour data could be used to mill a Full Zirconia Crown (FZC – See this months’ Web Special!) providing you with a strong and tooth-shaded crown.  (I personally haven’t tried this – I wonder what thickness of zirconia is necessary to prevent a gray cast  emanating from the titanium?  I suppose you could apply an opaquer to the coronal portion of the abutment, as long as you accounted for the thickness of the opaque application in the design process.)  Finally, you might consider prescribing a Press-to-Metal restoration like our Pulse Interface crowns.  The 3Shape software does a fantastic job of creating an anatomical coping based on the full contour data insuring adequate support of the pressed ceramic.

In the more esthetic areas of the mouth, let’s assume you select zirconia as the material for your abutment.  We’ve already demonstrated the full contour pattern being used to press e.Max.  And, just as simply as the aforementioned Press-to-Metal process, we could just as easily create an anatomical zirconia coping and a pressable pattern for use with CZR Press or PM9.  Lastly, we could just output the anatomical zirconia coping and hand-layer the final restoration with Vita’s VM9 or Creation Zi-F ceramics.  (Almost forgot – you can even chose to have the coronal portion of your zirconia abutment designed like an anatomical coping, then bake ceramic directly to the abutment for a simple, one-piece,  screw-down restoration – provided the screw access hole is positioned correctly.)

Obviously, there are many alternatives provided by 3Shape and its “partners”.  However, there are a few holes, so here’s my wish list -

1.  Somebody at 3M needs to give serious consideration to allowing STL files from other scanners for use with the Lava milling machines.  3M has the number one brand of zirconia in the market place, but they’re rapidly losing market share.  I think a major factor, aside from the high cost of Lava zirconia,  is the quality of the Lava Scan software compared to other systems like 3Shape or DentalWings.  Open architecture is the way of the future – bury your head in the sand and well, get buried…

2.  This one’s for 3Shape – I like the custom abutment software, but there are elements of Nobel Biocare’s NobelProcera system that I would like to see adopted.  First, I like the way NobelProcera’s system allows the user to automatically taper the coronal portion of the abutment at a user-defined angulation with a touch of a button.  3Shape’s tools for manipulating the abutment head could lead you to design an abutment with an undercut with respect to the path of insertion of the final restoration if you’re not careful.  Also, the lack of an automatic paralleling tool for multiple abutments makes designing cases for bridgework tedious, at best.

Hey, nobody’s perfect!

But, you’re really close….

© 2009, Jeff Saylors. All rights reserved.