CBCT Scatter - A Thing of the Past?

A couple of years ago we introduced the No-Scan Appliance technique for CBCT implant planning. It allows doctors to simply capture a CT scan, models, and a bite, to plan a surgical guide, and to skip the radiographic scan-appliance step. A contraindication to this technique has been the presence of metal-based restorations, which cause scatter and usually necessitate a scan appliance. We recently discovered a bite material called Memosil (Heraeus Kulzer) that suppresses scatter. The material is viscous, and will require a few layers to adequately cover the entire restoration. Once applied, it allows a CT scan to be captured. As with all implant CT scans the arches must be separated with cotton rolls. This technique makes unnecessary the extra appointment and the cost of a scan appliance. 2 / 50 Milliliter Tubes $101.70 (Benco, Patterson etc)

BLueSkyBio - NEW VERSION 3 - NOW AVAILABLE! FREE

This is a copy of BlueSkyBio's advertisement

 

·  Absolutely no charge or purchase requirements.

·  Great for case analysis and / or computer guided surgery

·  Software is Mac OS X and Windows compatible.

·  Surgical guides can be fabricated for all implant systems. 

·  Use any computer guided surgical kit.

·  High quality guide fabrication.

·  Install on as many computers as you like.

·    Support and training at no charge.

Zimmer Trabecular Implants

Left Bone Right Trebecular Metal

 “Trabecular MetalTM implants are fabricated of elemental tantalum metal using a vapor deposition technique to create a metallic strut configuration that is similar to trabecular bone. The resulting crystalline nano-texture permits direct bone apposition” – Zimmer Dental.

That’s a mouthful, and in essence means Zimmer’s new implant looks and acts like bone. The new design presumably results in quicker and stronger integration. The designed voids are much larger than natural bone, allowing more, and faster, ‘ingrowth’ (natural bone growing into the implant). This design provides more flexibility, and exhibits mechanical properties closer to cancellous bone than any other material.

Identify Implant Parts On-Line

When you have an impression post, analog, screw, implant, etc., and are uncertain of the brand or system, use our new web site to conduct a search. You will find high-resolution images and descriptions of all the major implant companies, and even a few unfamiliar ones. You can even use an x-ray of an implant to determine its manufacturer. Once you’ve found the brand, use the site to choose from the many restorative options available from ROE. 


 

CBCT Update - Simplant Master Site

Last year ROE became a FastTrack, SimPlant Master Site. This means we now offer a fast conversion service. We also provide quicker turnaround on SimPlant guides. Rather than mail models to Europe, we now scan the models and e-mail the .stl file.


 

Transmucosal Abutments What are they and how do they help?

Transmucosal or multi-unit abutments are permanent abutments used to bring the restorative platform of an implant from the bone level to the tissue level. Rather than struggle with ‘sluffing’ tissue around the implant during restorative and maintenance procedures, these abutments support and protect the tissue. They are very effective when multiple implants are placed in deep, thin biotype tissue. With these abutments, implant frameworks can be removed without the need to temporarily reinsert tissue-supporting healing-cuffs. Implant companies sell special multi-unit healing-cover-caps to protect the screw holes during the various procedures. In fact, these caps must be used

Transmucosal Abutments

during the framework construction phase to protect the exposed portion of the abutment. Other benefits of transmucosal include redirecting the trajectory of the prosthetic screws to more esthetic or functional direction, correcting angles of divergently placed implants to allow easier case-seating, and assisting with determining framework passivity.

Capturing impressions with multi-unit abutment transfer-copings is simpler than implant-level impressions, and prevents many time-consuming challenges inherent in complex cases. When ordering transmucosal abutments, be sure to include the special impression-transfers and healing-cover-caps. If you need assistance, or have questions about ordering, please call us.

TLZ-SRB - Zirconia Srew-Retained Bridge

The ultimate fixed implant restoration is now available from ROE. No more concerns about acrylic breakage, teeth popping-off or maintenance. When restoring 4 or more implants, partial or full-arch, consider this extremely durable, affordable and state-of-the-art prosthetic.

What does it include?

• TLZ-SRB bridge
• titanium interfaces and screws
• CAD PMMA prototype to verify accuracy & esthetics

Digital Scan Caps

Offices equipped with digital impression machines (iTero & Lava COS) can now transfer implant position directly to the laboratory via special scan caps. These coded, aluminum, digital-impression posts are seated and thumb-tightened into implants and scanned. With this information ROE creates a virtual implant model for abutment and restoration design. There are several advantages to this service. First, the soft-tissue architecture is precisely captured and used to create ideal emergence and margin placement. Second, digital impressions are received by our laboratory very quickly allowing us to design abutments and restorations earlier, leading to much quicker turnaround time. And third, digital files are imported into ROE’s iRis (intelligent restorative individualized system) to engineer restorations to your specific parameters. Scan caps can be ordered through ROE in both plastic and radiopaque aluminum.

All-On-4 Quick Steps

The All On 4 Immediate Hybrid Technique is becoming an increasingly popular restoration. ROE has been closely involved in this process from the very beginning and provides complete restorative support from surgical guidance and in-office lab support to the final hybrid design and fabrication. Typically, the final restorative process is a five- or six-appointment sequence, preliminary impressions, final impression, a bite registration and fit verifi cation, tooth try-in, a bar try-in, and seating. We have developed a new streamlined process that eliminates half of these original steps. This technique requires one of two approaches. One option has the dentist perform a pick-up impression of the provisional, and articulate the master casts in the office. The second option requires the doctor to send the picked-up provisional to the lab to be mounted and finished, leaving the patient without the provisional for 2-3 days. Alternatively, arrangements could be made to have the patient bring the records to the laboratory to expedite the process to one day or less. To complete the pick-up, long open-tray screws must be used. Also, if the pick-up impression is compromised during the separation procedure, an alginate study cast must be captured so we can duplicate the set-up. If you are interested in more information on this technique, Joe Ambrose CDT (ext 303) will be happy to discuss it with you, or may simply request the Modified All on 4 Technique sheet.

Heraeus Kulzer Mondial Teeth

In our last ROE Reports we wrote about the many exciting changes we’ve made to our implant-supported hybrids and overdentures. One update was the adoption of the Mondial tooth line (Heraeus Kulzer). These premium teeth are ideal for implant prosthetics due to proven, clinical success at both the Malo Clinics and ClearChoice®. New NanoPearl® technology makes these teeth much stronger and more resistant  to wear than PMMA teeth. In fact, an independent study conducted by Tufts University found them to be the #1 wear-resistant tooth. Also, according to Heraeus, there is a true chemical bond to acrylic. These key benefits will increase longevity. It is important to note that the switch to these premium teeth for implant cases does not affect our recently introduced All-in-One pricing. Special shade and mold guides are available through ROE.

All-On-4 Support

When you need support planning and restoring All-On-4 cases, trust ROE. We work with specialists and their referring dentists in Central and Northern Ohio with preplanning, provisional and final restorations, as well as chairside assistance the day of surgery. Below are the implant companies that offer specific All-On-4 type systems. We also perform this procedure using Thommen and Straumann implants.

Nobel Biocare - All-On-4

3i - Diem2

Zimmer - RevitaliZe

 Astra Tech - Uni-for-Fixed

The fee for this service is $2899. Our comprehensive service includes the provisional denture, the definitive hybrid prosthesis, custom trays, models, special soft-tissue model, articulation, standard and processed bite rim, fit verification jig, set-ups, resets, acrylic finish, one full set of premium teeth, one set of economy teeth, protective night guard, iRis titanium CAD/CAM components, final screws for the bar, analogs. Price excludes in-office technician labor, impression transfers, abutments, shipping and tax.

These fees represent maximum costs for the specified design. Actual fees may be less depending upon processes which may not be required or might be performed clinically. Individual fees will be itemized and billed at the time service is rendered. Prices are subject to change without notice.

Upcoming Educational Webinar

Webinar:  Maximizing Computer Guided Surgery for You and Your Patients
(1 CE, no charge)

REGISTER NOW

Presented by: Joe Ambrose C.D.T., Technical Director at ROE Dental Lab
Sponsored by:  Blue Sky Bio
Date:  April 17th, 2012. 9PM Eastern, 8PM Central, 7PM Mountain, 6PM Pacific

COURSE DESCRIPTION: Joe Ambrose C.D.T., the Technical Director at ROE Dental Lab, will present the process and advantages of the "No Scan Appliance" surgical template protocol for your practice and your patients. Mr. Ambrose will present and discuss the tools the dentist and the lab have at their disposal to help ensure phenomenal results surgically and prosthetically including virtual articulation, surgical kits and drill stops. 
COURSE OBJECTIVES: The course objective is to educate dentists about computer guided surgical techniques and procedures that can be advantages to them, their practice and the patient. The course will be presented as an online educational webinar at no cost, provided by Blue Sky Bio, LLC. 1 CE credit will be awarded to attendees within 30 days of course. Treatment plans and surgical images may be presented in the BSP software, slideshow / presentation format or as individual images.  

REGISTER NOW

Z-Systems’ Zirconia Implants

Z-Systems is a Swiss manufacturer of metal-free dental implants. Its ceramic implant systems, Z-Look3 and Z-Look3 EVO are made of a special ZrO2-TZP-A-Bio HIP Zirconia. A special production process incorporates this unique bio-ceramic to create 100% zirconia implants which satisfies the cosmetic demands of anterior cases.

Z-Systems have been approved by several safety regulatory agencies across the globe, including the U.S. Food and Drug Administration (since 2007), and has over 6 years clinical experience and 20,000 implants in use. The promise of an esthetic, healthy, and safe alternative to metal implants is appealing. Z-Systems USA Inc. can be reached by calling (877) 874 9407.

Implant Supported Denture Process - Improvments

Within the last six months we have made several improvements in the materials and processes used for screw-down, fixed-detachable hybrid dentures and overdenture cases.

First, to ensure that we are processing at optimal levels we completely updated our premium Ivocap processing system: replaced flasks, injectors and the processing bath. Second, all bar cases are now processed on a separate analog model. Screwing the bar down at processing ensures the best result. Third, we redesigned our CAD/CAM bars and are now placing titanium posts within the long axis of all denture teeth for added tooth support. Fourth, the standard teeth we use in implant-borne removable prosthetics have been changed to Heraeus Kulzer, Mondial and Mondial i Denture Teeth. Research has shown that these teeth have a stronger bond to acrylic. In fact, these teeth are used by ClearChoice Centers and at the Malo Clinic, originators of the All-on-4 process. Finally, we now provide a vacuum-formed night-guard to protect the appliance from nocturnal parafunction. We believe these five improvements have added to the long-term success of our restorations and reduced the maintenance for doctor and patient.

All.In.One Fixed-Fee Implant Restorations

We are pleased to report that state-of-the-art CAD technology and our tech-savvy team of CAD/CAM technicians enable us to reduce fees and turnaround time on our premium, patient-specific, iRis custom abutment and bar implant prosthetics. We call our simple and straightforward fee structure All.In.One. It is intended to remove the uncertainty surrounding lab fees. These low fees, and our decades of restorative experience, can help you become more efficient and profitable in the restoration of implants   while providing optimal treatment.

 

Fees for fixed restorations are per implant and include the following: special soft-tissue model, analog, articulation, iRis custom abutment, CAD abutment seating jig, and fixed restorations, including noble alloy. Price excludes high-noble alloy, shipping, and tax. Removable fees are per arch and include: custom trays, models, special soft-tissue model, articulation, standard and processed bite rim, fit-verification jig, setups, resets, cast metal or Fiber Force strengthening substructure, acrylic  finish, one full set of premium teeth, one set of economy teeth, protective night guard, iRis titanium CAD/CAM bar on an unlimited number of implants, final screws for bar, analogs, and your choice of standard attachments (e.g., locators, hader clips, era, o-rings, bredent). Price excludes in-office technician labor, impression transfer, transmucosal  and multiunit abutments (usually not required) shipping, and tax.

The fees represent maximum costs for the specified designs (call for new Implant Fee schedule). Actual fees may be lower depending upon processes that may not be required or performed clinically. Individual fees will be itemized and billed at the time service is rendered. All.In.One components are produced by ROE’s preferred suppliers. When original manufacturer parts are requested there will be an increased cost.

iRis abutments and bars featured in our All.In.One service are fabricated on the ULTRASONIC 20, a 5-axis, robotic milling machine capable of 42,000 rpm. The 2.3 ton machine is considered the most stable in its class and is capable of milling both titanium and zirconia from single unit to full roundhouse bridges, as well as implant bar frameworks, all within 10 microns.

Zimmer Angled Abutments - 30 degrees

Zimmer has announced release of their Angled Tapered Abutments. These abutments compensate for off-axis implants for expanded surgical options, such as All-On-4 type situations, to maximize the use of available bone, avoid the alveolar nerve and sinus, and minimize cantilevers for prostheses.

Angulation correction:
15° Angled Tapered Abutment: Corrects up to 30° of divergence
30° Angled Tapered Abutment: Corrects up to 45° of divergence