In this edition of the Medit Times, we’re delighted to share the workflows of Dr. Alexandru Bogdan.
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Case #1
Rims for Edentulous Patients
This patient came in with an old lower denture and an upper partial that lost teeth support.
Upper and lower edentulous arches were scanned and aligned with the impression material for an approximate bite record.
Upper and lower rims were fabricated to establish a true inter-arch relationship and to help with the alignment of the soft tissue.
Rims were fixed together by drilling holes and binding them with flowable composite.
Small spheres of dense composite were used to establish stable contact.
Scanning of the result object was done using the Medit i700 wireless.
The green on the reliability map shows that the result was within the range of 100 microns, which is perfectly acceptable for a complex object, compared to the same object scanned in the lab.
Both CT-to-CT and CT-to-scan alignments were performed for the purpose of creating a surgical guide.
Case #2
Dental Bridge Replacement
The patient was presented with two old bridges that no longer fit.
Dr. Alexandru Bogdan conducted a pre-op assessment, including a partial face scan, smiling and retracted photos, and a double CT scan.
Based on the plan, the patient agreed to an all-on-six treatment on the upper arch.
A KOIS device was designed using Medit Splints and printed on a Phrozen Mini 4k.
After removing the old bridges, the upper and lower wax-ups were seated.
The bite was adjusted and recorded again together with some minor modifications, then transferred back into CAD.
The resulting modified files were imported into exoplan, and implant planning was done with prosthetic-driven adjustments.
A guide was manufactured, and after the day of the surgery, the second wax-up file will be used to fabricate a temporary bridge.
Case #3
Mandibular Defect Treatment
A patient with a severe mandibular defect agreed to undergo a grafting procedure prior to implant placement.
The patient’s preoperative data was acquired using the Medit i700 wireless and aligned to the CT mesh generated with the Diagnocat automatic AI-driven extraction tool.
Virtual crowns were generated using the exoplan software, and two implants were placed in the ideal position with the crowns.
The implants were placed at bone level and exported as virtual dummies along with the bone mesh.
They were merged together in Medit Design, and the bone was modeled to cover the implants.
Over the new mesh, a membrane was constructed with screw channels to facilitate fixation to the bone.
The length and direction of the screw were checked with respect to the position of the alveolar nerve.
Finally, a zirconia mesh was fabricated and sterilized.
During surgery, the placement of the membrane was easy and precise.
It was seated well on the bone and healing was uneventful, with no dehiscence observed.
At eight months post-op, the bone had fully healed and ready for the placement of the initially planned implants.
