triple scan protocol (Dr. Gross) - a new and effective protocol for 3D planning and guided surgery of partially edentulous cases Cortex guide - complete service for advanced 3D planning and guided surgery of dental implants
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The document outlines the triple scan technique developed by Dr. Michael Gross, which enhances computer-guided planning and flapless implant placement for partial edentulous cases. It contrasts with the traditional dual scan technique, emphasizing improved instrumentation, reduced costs, and expanded indications for various dental situations. The protocol includes detailed steps for 3D scanning, planning implants' positions, and clinical support options for dental professionals.
triple scan protocol (Dr. Gross) - a new and effective protocol for 3D planning and guided surgery of partially edentulous cases Cortex guide - complete service for advanced 3D planning and guided surgery of dental implants
- 1. Triple scan technique (Dr. Gross) A new and effective protocol for computer guided planning and flapless implant placement for partial edentulous cases Dr. Michael Gross Implantologist and international lecturer Scientific consultant for dental implant industry
- 2. Lecture program • Classic protocol : dual scan technique • Guided surgery and immediate loading • Simplified instrumentation for expanded indication • Triple scan technique and case scenarios • Clinical support and education
- 3. Lecture program • Classic protocol : dual scan technique • Guided surgery and immediate loading • Simplified instrumentation for expanded indication • Triple scan technique and case scenarios • Clinical support and education
- 4. 3D planning with visualization of radiographic denture 3D scan of radiographic denture alone and alignment on 3D scan of patient bone 3D Scan of patient bone wearing radiographic denture with x-ray markers
- 5. File transfer over internet of planning data Precise 3D planning of position and angulation of implants and guide pins 3D relation between planned implant positions and radiographic denture Fabrication of surgical guide converting radiographic denture
- 10. Radiographic markers in denture included with guttapercha or Cavit
- 21. Lecture program • Classic protocol : dual scan technique • Guided surgery and immediate loading • Simplified instrumentation for expanded indication • Triple scan technique and case scenarios • Clinical support and education
- 22. Guided surgery and immediate loading • Dual scan protocol was developed for edentulous cases with immediate loading • Promoted for teeth-in-a-day with prefabricated restoration • This requires implant placement over surgical guide and therefore titanium sleeves in surgical guide • This requires development of guided surgery kit with many components – costs – • If not all planned implants have required primary stability, prefabricated restoration is useless
- 23. Lecture program • Classic protocol : dual scan technique • Guided surgery and immediate loading • Simplified instrumentation for expanded indication • Triple scan technique and case scenarios • Clinical support and education
- 24. Simplified instrumentation for expanded indication • Reduced instrumentation for compatibility • Eliminating the need of implant specific surgical guide kit – universal guidance of 2mm and 3 mm drill with depth stop • Eliminating the need of titanium sleeves – use of titanium drill guide handle 2mm and 3mm which is introduced in surgical guide • This expands indication because collision of titanium sleeves with close or inclinated implants is eliminated • In extremely narrow situations use of 2mm guide sleeves for use with 2mm drills
- 25. Simplified instrumentation for expanded indication • Reduced instrumentation for compatibility • Total inventory needed: 1.1 drill guide handle 2mm / 3mm 2.1 drill 2mm short with depth stop 3.1 drill 2mm long with depth stop 4.1 drill 3mm short with depth stop 5.1 drill 3mm long with depth stop 6.1 drill 1.6 mm for guide pin 7.3 guide pins (reusable) Costs: total only 712 US$ + shipping
- 26. Lecture program • Classic protocol : dual scan technique • Guided surgery and immediate loading • Simplified instrumentation for expanded indication • Triple scan technique and case scenarios • Clinical support and education
- 27. Triple scan technique • Most of implant cases are partially edentulous • Radiographic partial denture for dual scan has disadvantages – Fixation on residual teeth poor if not extended over them – Visibility of residual teeth compromised if covering them – Gingival contour of neighboring teeth and edentulous areas can only be estimated as underside of denture
- 28. Triple scan technique • Solution for partial edentulous cases 1. CT or CBCT scan of patient without any appliance in open occlusion 2. Optical scan of master cast (can be modified and imported at any time after CT or CBCT) 3. Optical scan of master cast with diagnostic wax-up (can be modified and imported at any time after CT or CBCT) 4. Alignment of both optical scans with 3D model of bone
- 29. Triple scan technique • Solution for partial edentulous cases 1. Implants can be backward-planned on cast with diagnostic wax-up with visualization of available bone, excellent details of teeth and soft tissue 2. Relation of implant and soft tissue depth can be verified with visualization of master cast without wax-up, excellent details of teeth and soft tissue 3. Relation of implant to crestal bone can be verified with visualization of bone without cast 4. Fabrication of tooth-supported surgical guide over master cast without wax-up
- 31. Dual scan technique • Indication for totally edentulous cases
- 32. Dual scan technique • Indication for totally edentulous cases
- 33. Dual scan technique • Indication for totally edentulous cases
- 34. Dual scan technique • Indication for totally edentulous cases
- 35. Dual scan technique • Indication for totally edentulous cases
- 36. Dual scan technique • applied for partially edentulous cases
- 37. Dual scan technique • applied for partially edentulous cases
- 38. Dual scan technique • applied for partially edentulous cases
- 39. Dual scan technique • applied for partially edentulous cases
- 40. Dual scan technique • applied for partially edentulous cases
- 41. Dual scan technique • applied for partially edentulous cases
- 42. Triple scan technique • applied for partially edentulous cases
- 43. Triple scan technique • applied for partially edentulous cases
- 44. Triple scan technique • Implants planned on wax-up cast
- 45. Triple scan technique • Implants relation to soft tissue
- 46. Triple scan technique • Implants relation to bone
- 47. Triple scan technique • Tooth-supported surgical guide
- 48. Triple scan technique • Extraction case, modified cast
- 49. Triple scan technique • Extraction case, modified cast
- 50. Triple scan technique • Extraction case, modified cast
- 51. Triple scan technique • Extraction case, angulation needed because of proximity canalis incisivus
- 52. Triple scan technique • Extraction case, would be collision with master sleeves, no problem with drill guide handle
- 53. Triple scan technique • Multiple changes on cast after CT scan, extractions and root canals done, planned extractions
- 54. Triple scan technique • Multiple changes on cast after CT scan, extractions and root canals done, planned extractions
- 55. Triple scan technique • Multiple changes on cast after CT scan, extractions and root canals done, planned extractions
- 56. Triple scan technique • Multiple changes on cast after CT scan, extractions and root canals done, planned extractions
- 57. Triple scan technique • Multiple changes on cast after CT scan, extractions and root canals done, planned extractions
- 58. 2 mm guide multiple extraction case with tooth-supported guide over 3 teeth as strategic support
- 71. Lecture program • Classic protocol : dual scan technique • Guided surgery and immediate loading • Simplified instrumentation for expanded indication • Triple scan technique and case scenarios • Clinical support and education
- 72. Clinical support • CORTEX guide - Complete service for 3D planning and fabrication of surgical guides • Provide surgical instruments at low-cost • Online help with skype and teamviewer • Simple data transfer over dropbox • No physical shipping needed • Free planning and viewing software Nemoscan
- 73. Clinical support • CORTEX guide - Complete service for 3D planning and fabrication of surgical guides • Turn-around time for guide fabrication 3-5 business days after final approval of planning • Different shipment options
- 74. Clinical support • CORTEX guide - Complete service for 3D planning and fabrication of surgical guides • Costs for complete service per case (regardless number of implants): – One jaw, one guide: 500 US$ plus shipping – Both jaws, two guides: 650 US$ plus shipping
- 75. Tel.: +1-809-736-9040 Cel.: +1-829-548-6135 Santiago – Llanos de Gurabo C./a Jacagua entrada km 7 Res. La Senda, casa 5 dds.michael.gross@gmail.com Contact: Dr. Michael Gross CORTEX guide www.cortex.dominicanhealth.org