Fun With Primescan and Atlantis
For those that have been on the fence with Primescan, or have not tried the Atlantis workflow, I thought I would share this fun "real-world" case we just finished recently. These are my favorite types of cases, where we can really make a difference for someone. Patient presents as an 80 year old woman who was wearing an ill fitting partial for awhile and was losing weight because eating was very difficult. She has some significant health issues and was told in Florida that she "could not have implants", which was obviously inaccurate. She saw an oral surgeon who we work with for placement of three implants and he bounced her over to me. Now, there are certainly plenty of other restorative concerns, but we wanted to address the immediate issue and get her back in function. Here is how she presented:
You can see in the next pic that she has a tight upper lip that we were fighting with, which made photos a challenge, but it also helped us restoratively because she had a low lip line and there was significant atrophy in the area over time. We debated pink porcelain over longer teeth, but as you will see in the finals it really didn't matter esthetically due to the tight lower lip line. But, most importantly, I love how the Primescan picks up everything, including the metal on her partial:
The double buccal bite made sure we were able to get a stable model:
Check out the depth of scan, into the implants:
So, we placed the IO FLO scanbodies and took our scans:
Love how it even captures the clasps-ridiculous. So, we sent the case to Atlantis and had them fabricate the abutments...they were able to parallel everything and send me the plan:
I approved the plan and they sent me the abutments and the core file for the bridge-I was able to take that core file and send it via connect off to the lab-so at this point I have not taken a single physical impression or touched a model, but we have abutments and a final fixed partial denture being manufactured. I also remembered this time to order the seating jig from Atlantis-makes life so much easier:
So, once the bridge came in from the lab, we had the patient come in. Popped in the seating jig and delivered the abutments in a few minutes-such a smooth process. There was blanching of the tissue but patient was never uncomfortable, and it went away after a few minutes:
Delivered the final bridge and we had a very happy patient:
She called me the next day all excited about how she went out to dinner with her husband and was able to eat...in the world of Italians, that is priority number one! All kidding aside, it was great to use the amazing technology and Atlantis workflow to tackle a challenging case and help her get healthy. Impressions would have been very difficult, but with Primescan it was unbelievably easy. Now, she is so excited she wants to start addressing the other areas as well...fun times in dentistry for sure!
Awesome work! This would have been so much harder and more expensive with an analog workflow.
Great job Ponz. I love knowing that there are a few elderly people who are willing to improve their quality of life.
love this case ponz. You can thank me later for making you use the jig. awesome result. The primescan is so badass!!
The jig is awesome-appreciate the recommendation, Rich. Nice that you were useful for a change.
Chuck, OS placed on his own.
Domenic, this was a straight zirconia bridge.
On 5/12/2019 at 10:31 pm, Patrick Oconnor said...silly question time
what is the purpose of the seating jig?
In multi-unit cases where each abutment can be seated in 6 positions it can take some time to seat them all in the correct orientation. The abutments fit in this jig only one way, and it allows you to seat all of the abutments in the correct orientation at the same time. It’s also required for zirconia abutments.
Best part of the story (beautiful case, btw!) was that this is an EIGHTY year-old woman, opting for implants and a real, tangible improvement in her quality of life. Love it
That's a beautiful case, thank you for taking and sharing such great photos! The Primescan scans look amazing.
In the last month I've finally set my Omnicam up with Atlantis. After some small hurdles on the phone with them getting my CEREC linked to their website, it has been an absolute breeze to get custom abutments back in a couple of days.
Anthony: When you send these core files to the lab has there been any pushback from them about not having the physical abutments and having to do all the work digitally? Was there confusion on their end at first about what you wanted to do? I've only done Atlantis abutments when it's a case that I was going to design and mill myself. I'm just trying to envision the conversation I would have with my lab guy to explain what I wanted done. Or is this pretty much in line with what they do anyways when they have a custom abutment made?
On 5/13/2019 at 4:44 am, Daniel Butterman said...On 5/12/2019 at 10:31 pm, Patrick Oconnor said...silly question time
what is the purpose of the seating jig?
In multi-unit cases where each abutment can be seated in 6 positions it can take some time to seat them all in the correct orientation. The abutments fit in this jig only one way, and it allows you to seat all of the abutments in the correct orientation at the same time. It’s also required for zirconia abutments.
Dan, to take it even a step further, It is a much safer way to place the abutment into the mouth without losing your grip on it and it going down the patients throat. I love these for any case I do, but especially for 1st and second molars where I dont have easy access
Hey Tyler-
The lab did call and ask if this was an implant case or a traditional crown and bridge case, but I just told them to treat it as a traditional case and design and mill the bridge. They were trying to figure out if they had to send it to their implant department or their crown and bridge department. There were no real issues with it otherwise-probably easier and faster for them to do this digitally than it is with physical abutments...but they also could have printed a model if they wanted to. Hope that answers it!
