Partially Edentulous Protocol When Using a Scan Center - Anterior Cases

rev March 28th, 2016 Page 1 of 2 ©2016 Guided Surgery Solutions, LLC. All Rights Reserved

Scan Appliance Method

Drill guides are constructed using three data sets, which are merged in implant planning software for surgical planning to provide visualization of the osseous anatomy, soft tissue, teeth, and future tooth position.

1. Patient Scan - The patient wearing scan applaince provides the osseous anatomyand teeth

2. Guide Model - A stone model of the arch provides the anatomy of the soft tissuesand teeth and is the surface upon which the drill guide is built

3. FutureTooth Position Model - Models of the patient wearing an existing prosthesisor a wax-up provide the data for positioning the implant relative to the prostheticenvelope

A scan appliance containing fiducial markers is made and used to orient the patient scan and guide model data sets for an accurate merge.

The patient must be motionless during the scan. A low resolution scan for a short time period usually provides the best results. Include all relevant anatomy in the scan, but avoid including head and neck anatomy not relevant for planning. Patients should not bite on scanner mouthpieces, as this will distort the alginate impression.

The fit of the scan appliance and the drill guide on the patient’s teeth is dependent on the quality of the stone model and, thereby, the accuracy of the impression. Smear the impression material (ex: alginate) onto the occlusal surfaces of the teeth and into undercuts by finger pressure before the impression tray is placed. Include entire palate for a maxillary model. Take care to avoid bubbles when pouring the model, since these may affect the quality of the model. We recommend applying a debubblizer (soapy water) to the alginate before the model is poured.

Data Set Needed to Order a Guide 1. DICOM files from CBCT of patient wearing scan appliance with fiducial

markers2. DICOM files from CBCT of stone model wearing the scan appliance with

fiducial markers3. FutureToothTM position data from either:

a. DICOM files from CBCT of stone model of a wax-up model orb. DICOM files from CBCT of stone model of the patient wearing an

existing prosthesis.c. FutureTooth position data are optional for single tooth anterior cases

Detailed protocol on following page

Partially Edentulous Protocol When Using a Scan Center - Anterior

rev March 28th, 2016 Page 2 of 2 ©2016 Guided Surgery Solutions, LLC. All Rights Reserved

1. Register your case at www.guidedsurgerysolutions.com/place-order/

2. Guide Model: Take an impression and pour the model

3. Fabricate a scan appliance: Block out majorundercuts in model. Vacuum-form 0.060 soft EVAsplint material onto the stone model Apply5 Suremark VF-10 self-adhesive glass bead markerssymmetrically to the stent, at or apical to themucogingival junction (additional adhesive formarkers may be needed)

4. Send patient to scan center with the scan appliance, guide model, and the followinginstructions:

a. CBCT scan the patient wearing the scan appliance. To ensure the scanappliance is stable and fits on the dentition the same as it does on the model, havethe patient bite gently on cotton rolls placed on right and left sides of scanappliance

b. Place the scan appliance on the stone model

c. CBCT scan the guide model wearing the scan appliance orienting the scanappliance/stone model in the scanner as it was in the patient (upper versus lower).Use settings similar to the following:

i. FOV: 8.5 cm (W) x 4-5 cm (H) for single archii. Voxel: 0.2 mmiii. Scan time: 12.8 sec

d. Return model and scan appliance to dental office

5. FutureTooth Position Model

a. Take impression of patient wearing an existing prosthesis or of wax up model

b. Pour model, remove model from impression tray and scan

6. The guide model wearing the scan appliance and FutureTooth position model may be sentto Guided Surgery Solutions for scanning

7. Create a folder for the patient in your shared GSS Dropbox folder and upload:

a. Patient DICOM file

b. Guide model DICOM file

c. FutureTooth position model DICOM file

8. Mail the guide model, scan appliance and FutureTooth Position modelto Guided Surgery Solutions, LLC, 564 Main Street, Suite 203, Waltham, MA 02452