IOS Impression by iTero
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The document discusses various dental impression techniques, comparing traditional methods with digital technologies such as CAD/CAM systems and intraoral scanning. It outlines different systems, their features, materials used, and case delivery methods. Additionally, it highlights the accuracy of digital impressions compared to conventional techniques, suggesting the former can serve as a clinical alternative for fixed dental restorations.
IOS Impression by iTero
- 1. tooth prepara)on impression tradi)onal op)cal stone model virtual model waxing cas)ng ceramic layering finishing CAD CAM finishing
- 2. preparation impression traditional stone model Waxing (Casting) Ceramic layering Finishing
- 3. preparation OPTICAL IMPRESSION scanner imaging CAD CAM finishing
- 4. Optical impression Optical technology Laser technology C.O.S. (3M Espe) ! Fast Scan (IOS Technologies) ! Intraoral camera (Densys3D) ! Cerec Bluecam (Sirona) E4D (D4D Technologies) ! iTero (Cadent) ! 3D Progress (MHT)
- 5. Optical Technology CCD - CMOS Acquisition of static or dynamic images that with different imaging using algorythm are meta-ricombined modeling a three-dimensional virtual images Laser Technology (Confocal technique) LASER Laser beam is convergent in small spots and with an array of oscillating mirrors laser is moved through the entire observation field for scanning all focal planes.
- 6. 3M - C.O.S. ! ! ! System type : Chairside CAD/CAM Architecture : Selec)vely OpenClosed* Powder : Yes ? Lab Equipment : COS soHware , LavaDesign, 3Shape, Dental Wings Case Delivery : Doctor > Margin Making > Milling Center > Laboratory Web Interface, E-‐mail. FTP, Sneaker-‐net Case Type : Scan Only Materials : LAVA, 3rd party Zirconia, LAVA DVS, Wax, e.Max CAD, Chrome-‐cobalt Special Features : 3D margin making, Scan file edi)ng, (wax on /wax off)
- 7. IOS Technologies FastScan ! !!! System type : Chairside digital impression Architecture : Open Powder : ??? Lab Equipment : 3Shape, Dental Wings, Dent CAD Case Delivery : Doctor > Laboratory Web interface, E-‐mail, FTP Case Type : Scan Only Materials : 3rd party Zirconia, Wax, e.Max CAD, Chrome-‐cobalt Special Features :
- 8. Densys3D ! ! ! System type : Chairside digital impression Architecture : Open Powder : ??? Lab Equipment : 3Shape, Dental Wings, Dent CAD Case Delivery : Doctor (Margin Marking) > Laboratory Web interface Case Type : Scan Only Materials : 3rd party Zirconia, Wax, e.Max CAD, Chrome-‐cobalt Special Features :
- 9. D4D Technologies – E4D ! ! ! System type : Chairside CAD/CAM Architecture : Closed* Powder : Op)onal Lab Equipment : Labworks – Scanner/Mill, E4D Studio Case Delivery : SkyNetwork, LAN/Ethernet Case Type : Scan Only, or Scan and Designed Materials : Empress CAD, e.Max CAD, Paradigm C, Paradign Z100, Empress Zircad, BOB (acrylic), Telocad (provisional) Special Features : Mul)ple unit edi)ng, rubber tooth (sophis)cated, Milling independent on IOD status, SOS
- 10. iTero Cadent ! ! ! System type : Chairside digital impression Architecture : Open Powder : NO Lab Equipment : Cadent Lab SoHware > 3Shape, Dental Wings, Dent CAD Case Delivery : Doctor > Margin Marking > Milling Center > Laboratory Web interface, E-‐mail, FTP, Sneaker-‐net Case Type : Scan Only Materials : 3rd party Zirconia, Wax, e.Max CAD, Chrome-‐cobalt Special Features : Margin line extension
- 11. 3D Progress MHT ! ! ! System type : Chairside digital impression Architecture : Open Powder : NO/YES (Yes on metals) Lab Equipment : 3Shape, Dental Wings, Dent CAD Case Delivery : Doctor (Margin Marking) > Laboratory Web interface Case Type : Scan Only Materials : 3rd party Zirconia, Wax, e.Max CAD, Chrome-‐cobalt Special Features :
- 12. Clon3D Progress IODIS ! ! ! System type : Chairside digital impression Architecture : Open Powder : NO/YES (Yes on metals) Lab Equipment : 3Shape, Dental Wings, Dent CAD Case Delivery : Doctor (Margin Marking) > Laboratory Web interface Case Type : Scan Only Materials : 3rd party Zirconia, Wax, e.Max CAD, Chrome-‐cobalt Special Features :
- 13. iTero Cadent ! ! ! System type : Chairside digital impression Architecture : Open Powder : NO Lab Equipment : Cadent Lab SoHware > 3Shape, Dental Wings, Dent CAD Case Delivery : Doctor > Margin Marking > Milling Center > Laboratory Web interface, E-‐mail, FTP, Sneaker-‐net Case Type : Scan Only Materials : 3rd party Zirconia, Wax, e.Max CAD, Chrome-‐cobalt Special Features : Margin line extension
- 14. Sirona - CEREC ! ! ! System type : Chairside CAD/CAM Architecture : Closed* Powder : Yes Lab Equipment : inLAB, inLAB MC XL Case Delivery : Cerec Connect, LAN/Ethernet, E-‐mail, FTP, Sneaker.net Materials : Cerec Bloc, Empress CAD, e.Max CAD, Paradigm C, inCoris Zi, InCoris Al, Vita Mark II, Vita Triluxe, Vita In Ceram Spinell, Al, Zirconia, Vita YZ Special Features : Biogeneric Library, Cone beam integra)on, abutments
- 15. Cerec optical impression Cerec 1 : 50 micron ! Cerec 2 : 25 micron ! Cerec 3 : 25 micron
- 16. Collimating lens
- 17. Collimating lens
- 19. Projecting an array of lines
- 21. Sequence of images (4) Immagine di un modello virtuale ?
- 22. Virtual model 1. Op)cal impression ! 2. Laser scan of the stone model ! 3. Op)cal scan of the stone model
- 23. Virtual model 1. Op)cal impression ! 2. Laser scan of the stone model ! 3. Op)cal scan of the stone model
- 24. CEREC optical impression 1. All the areas of interest has to be clearly visible ! 2. The surfaces have to be reflec)ng
- 25. Brand and types of powdering (optical impression)
- 30. Cerec optical impression Cerec 1 : 50 micron ! Cerec 2 : 25 micron ! Cerec 3 : 25 micron ! Cerec 3 BC: 20 micron
- 32. Die CAD/CAM-‐Systemkompetenz von Sirona. 32 CEREC Omnicam
- 33. CEREC Omnicam – Scanning simplicity.
- 34. CEREC Omnicam Powder-‐free scanning 3D impressions in natural color
- 35. CEREC Omnicam – Scanning simplicity. 3D scans in color PPossible Benefits ! § Intuitive orientation in the patient’s mouth § Good differentiation between tooth structure and gingiva § Differentiation from amalgam, gold or composite
- 36. Screenshots with CEREC SW 4.0.4
- 38. Camera CEREC Omnicam CEREC Bluecam Imaging technique Con)nuous color imaging Single image acquisi)on Area of applica)on Single tooth, quadrant, full jaw. Single tooth, quadrant (full jaw possible). Dimensions Overall length: 228 mm Length of camera sleeve: 108 mm Height and width of the )p: 16 mm Overall length: 206 mm Length of the camera )p: 86 mm Height and width of the )p: 22 x 17 mm Weight 313 g 270 g Clearance/depth of field The camera is moved closely over the tooth surface 0 -‐ 15 mm The camera can be placed directly on the teeth. Open data* ü ü No charge for using Sirona Connect: ! ! (Transmission of impression data to an ü ü external laboratory) Can be combined with a milling unit ü ü 3D scans in color ü No powder coa)ng required ü
- 39. Ender A, Mehl A Full arch scans: conven)onal versus digital impression: an in-‐vitro study ! Int J Comp Dent 2011:14-‐11:21
- 40. Full arch scans: conven)onal versus digital impression: an in-‐vitro study ! Int J Comp Dent 2011:14-‐11:21 Conclusion ! These in-vitro results show that accuracy of the digital impression Ender A, Mehl A is similar to that of the conventional impressions.
- 41. Seelbach P, Brueckel C, Wöstmann B ! Accuracy of digital and conven)onal impression techniques and workflow ! Clin Oral Invest 2013 DOI 10.1007/s00784-‐012-‐0864-‐4
- 42. Seelbach P, Brueckel C, Wöstmann B ! Accuracy of digital and conven)onal impression techniques and workflow ! Clin Oral Invest 2013 DOI 10.1007/s00784-‐012-‐0864-‐4 Conclusions ! Within the limita+ons of this in vitro study, it can be stated that digital impression systems allow the fabrica+on of fixed prosthe+c restora+ons with similar accuracy as conven+onal impression methods. ! Clinical relevance ! Digital impression techniques can be regarded as a clinical alterna+ve to conven+onal impressions for fixed dental restora+ons.
- 43. 43 Trasferisce - geometria dell’impianto - dimensione dell’impianto - posizione 3D nell’arcata ! ! ! ! ! ! ! ! coping tradizionale scan body
- 44. L’accuratezza del processo di digitalizzazione dipende da: ! - tecnica di scansione del clinico (a zig-zag o lineare) - sistema di scanner utilizzato (microscopia cofocale, paralella, a raggio laser, a luce strutturata) - forma e dimensioni dello scan body 44
- 45. Questi modelli non sono concepiti per realizzare delle protesi dall’inizio Possono solo essere utilizzati per posizionare le strutture realizzate tramite le tecnologie cad-cam per poter applicare la ceramica e controllare i punti di contatto. 45
- 46. 46 METODI DI FABBRICAZIONE ! Sottrattivo Additivo ! Fresatura da un blocco Sinterizzazione al laser di polvere Polimetilmetacrilato (PMMA) Resina composita Leghe metalliche (vili, titanio) Vetro ceramiche (Disilicato di litio, leucite) Zirconia
- 47. Future Developments ! 1. Control of the costs 2. Enahncement of the application spectrum (edentulous jaw) 3. Introduction of trans-gengival scanners 4. Ultrasonography (accuracy?) 5. Optical coherence tomography (OCT) !!!
- 48. Joda and Bragger IOS Work Time for Single Unit (In minutes) Economical and clinical process analysis for implant-supported single-unit reconstructions. Clin Impl Dent Rel Res (In press) Clinic 1 (Traditional vs digital Lab (abutment and crown) Digital 14 160 Conventional 18 190 Clinic 2 (try-in) Clinic 3 (Clinical Adjustments) Total 12 45% 180 15 100% 220
- 50. LIMITS: ! - USEFUL ONLY FOR SMALL RESTORATIONS - COSTS - NEED FOR USB ATTACHMENT TO PC WITHOUT TROLLEY - - STL FILES - - SIMPLIFICATION OF PROCEDURES - - MANAGEMENT OF SOFT TISSUES…WE NEED - NEW TECHNOLOGY TO PASS THE SOFT TISSUE - AND RECORD HARD TISSUE ! !
- 51. 51 Problemi * Acquisizione dei dati per arcate intere è ancora imprecisa * Per molti sistemi è necessario applicare una polvere opacizzata che non è facilmente controllabile * Per i pilastri naturali, se le preparazioni sono umide, la polvere tende a creare grumi Costi (scanner e procedura) * Per elementi multipli l’unione di diversi gruppi di dati può generare delle inesattezze * Non è ancora possibile catturare un margine intrasulculare senza esporlo tramire retrazione gengivale . Necessità di fili di retrazione.
- 52. 52 Potenziali benefici Impronta tradizionale Scanner intraorale Comfort del paziente No Si Feedback immediato sulla qualità delle preparazioni No Ni Possibilità di creare n modelli con lo stesso grado di distorsione, senza stoccarli No Si
- 53. 53 SCANNER INTRAORALI Lava Itero BlueCam Cerec ZFX Accuratezza della scansione 6-11 um 40 um 25 um 40 um Possibilità scansionare denti singoli & multipli si si si si Possibilità di scansionare impianti singoli & multipli 3i certified solo x straumann si con scan body si con scan body Trios 20 um si si con scan body Costs (Euro) 21-35.000 12.000 25.000 53.000 27.000 Scan Type Monographic/True color Monographic Monographic True color Monographic