Implant software
The use of implant software (for diagnostics and digital planning of implants) is a link in the digital processing chain and follows imaging procedures. It can process 2D and 3D X-ray data (from digital orthopantomographs, CTs or CBCTs) as well as clinical data scanned with intraoral scanners and visualise it with integrated viewer programmes. Apart from extremely precise, distortion-free images (including clear alignment of structures by overlapping partial images), aids such as scanbodies of known 3D geometry are also essential for transferring dimensions reliably. The image can be rotated three-dimensionally as required and flat (cross-sections) or curved 2D views calculated. Important structures (such as the mandibular canal) can be coloured in 3D images. Measuring instruments can be faded in for determining distances or angles thus making implant software suitable for preoperative diagnostics (bone volumes, bone quality, arrangement of important anatomical structures).
For backward planning, implant software can be used for achieving prosthetic objectives (e.g. by fading set-ups or wax-ups of the planned prosthetic restoration into the scan) by defining the parameters for implants and bone availability and evaluating whether augmentation is necessary.
Datasets of frequently used implants and abutments from virtual libraries stored in the implant software can be embedded in the optical three-dimensional image. This permits realistic planning of the number, dimensions (length, diameter), positioning and alignment of the implants.
Implant software
When implant software is used in conjunction with additional CAD programmes or modules, which include virtual teeth, occlusal surfaces, connectors and other prosthetic elements, the prosthesis can be planned entirely digitally. Together with CAM procedures, preoperative fabrication of (bone, tooth or mucosa supported) drilling templates with sleeves for guiding the drill during navigated implantation, custom abutments, temporary or even definitive superstructures is feasible.
One important demand placed on implant software is import/export compatibility (interfaces) with common data formats (such as Dicom and STL standard open formats). Proprietary systems with in-house formats are either tied to these (isolated applications) or can convert them to other (open) formats. In order to process the large datasets imported/exported by implant software, computer systems must possess sufficiently high data processing capacity and speed.
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Wax build-up technique Wax build-up technique The various anatomical structures (such as cusp tips and slopes as well as marginal ridges) are usually built up one after another by adding small portions of wax (often using differently coloured waxes for didactic purposes). The firm, special waxes first have to be melted at room temperature. This can be carried out by warming small portions on differently shaped working tips of hand instruments in an open flame (such as a gas burner) or using electrically heated instruments which provide for more accurate temperature control and avoid contamination (e.g. electric wax-knife, induction heaters, wax dipping units). The wax is applied drop-by-drop to ensure that the warmer molten wax added last fuses seamlessly with the firm, cooler material. After hardening, the wax pattern can be reduced by sculpting, milling guidance surfaces or drilling to add retainers. Modern procedures include flexible, occlusal preforms for adding contours to soft wax. In addition, wax preforms, such as for occlusal surfaces or bridge pontics, are available in various shapes and sizes. Recently, irreversible, light-curing materials have been introduced for use instead of reversible thermoplastic waxes. Wax preforms To ensure that the wax pattern can be released without being damaged, model surfaces, opposing dentition and preparations must be hardened/sealed with special lacquer (applied by spraying, brushing or dipping). These waxes are mostly relatively rigid/elastic after cooling. Attaching wax sprues to a removable framework supported on double crowns using a hand instrument When employing the lost wax technique, prefabricated wax sprues, bars and reservoirs are attached to the patterns. Once the pattern has been released and its sprues waxed onto the crucible former, it is invested in a casting ring with refractory investment material. The wax can then be burnt out residue-free and casting completed. Unlike standard wax build-up techniques, a diagnostic wax-up is not intended for fabricating an indirect restoration, but rather for simulating the appearance and/or external contouring for producing orientation templates. |