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Korolation with Medit i500

One of the greatest advantages of digital impressions is the ability to copy a pre-existing condition.  This has a lot of benefits, one of which is that the patient will not notice a difference in the new restoration vs. the old one.  For this to happen with the medit i500, you need an extra image catalog box.  Rumor is that this will be available in the near future.  Since we only have the upper and lower jaws, and the buccal bite to imagine into (and scanbody catalog boxes), what you can simply do is treat the case as if they are two separate patients.

Create a new patient, and scan the preop condition and save the case.  Once processed, you can export the case file in OBJ, PLY, or STL format.

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You can then launch a second case, where you take the opposing, the prepared arch, and the buccal bite images. You can download the Korolation OBJ case files and design along. Just remember, in exocad, the upper and lower arches from “patient #2″ will automatically articulate with each other, but you will have to manual import the preop scan and merge the prepped model and the pre-op models.

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Once you import in the pre-op condition, you can manually relate the models to each other by identifying common landmarks between the two models. After you perform alignment, you can then click on “Best fit matching”. The color scheme in exocad is a great guide in letting you know how well you have articulated the models together.

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The more blue you see in the Korolated models, the more reliable your stitch is and you can be assured of greater accuracy in your final restoration.

 
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Full Mouth Reconstruction with Medit i500

To see this case presented in webinar fashion click on the image and enter the members area for much greater detail and information


Pre-existing restorations that warranted replacement with an increase in vertical dimension.

Pre-existing restorations that warranted replacement with an increase in vertical dimension. The upper and lower arch were captured with the medit I500 and articulated together with enough clearance to accommodate new restorations and to restore the patient to an ideal tooth position.

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This video shows how the vertical dimension was captured with cotton rolls blocking out the tongue and the dark oro-pharynx, which usually spell trouble for an IOS

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The digital models were then imported into a third party software where a library of tooth morphologies are available for the clinician to choose from.

Once the appropriate library is chosen, the digital wax ups are performed. In the subsequent photos you can see the transparent overlay of the wax-ups to the original position of the existing dentition

 

Once the case is designed to the ideal vertical dimension then multiple shells can be fabricated for treatment. The wax up model can be uniformly reduced by .5mmm’s circumferentially and a temporary shell can be designed. Once the teeth are prepared, these shells can be relined and seated onto the preps.

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PREP AND TEMPS

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How was this done? Watch this video of how the case was imaged over a 4 hour time span in multiple segments

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FIRST VERTICAL DIMENSION
The initial vertical dimension was greater than desired and the tooth shape was too bulky in appearance.

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ADJUSTED TEMPORARIES AND NEW VERTICAL DIMENSION
Over the course of a few appointments, the vertical dimension was reduced and the temporaries were adjusted to the patient’s desires. The new upper and lower arch were captured with the Medit i500 and the jaws were related to each other.

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This was then imported into exocad where the prepped arches from a few weeks prior were force matched to the new bite

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After the upper jaw was related to the temps, the same was done with the lower arch. Great care was taken to make sure the arches were properly related to each other throughout the process

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CASE DESIGNS

The case was designed by CADENT BESSA, and the models were printed by Burbank Dental Lab with Carbon Printers. There restorations were milled and cut back and layered by Burbank Dental Lab

IMAGES OF PRINTED MODELS

 

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IMMEDIATE POST-OP PHOTOS AND VIDEO WITH IPHONE CAMERA

 

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ONE WEEK POST-OP RADIOGRAPHS / CEMENT CHECK

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