Implant Dentistry
DS Signature Workflow
Digital Dentistry
Blog Post
Digital dentistry has advanced rapidly in the last few years. In implant dentistry, digitisation has led to simpler, faster, and more predictable treatments, thus leading to a higher patient acceptance and satisfaction. The traditional procedures of replacement of a missing tooth or teeth have now been completely transformed, right from planning and execution to prosthesis fabrication and even maintenance by undertaking the digital workflow. Digital implant dentistry with Dentsply Sirona is designed to help the dentist deliver tailor made smiles for the patients, while optimising accuracy, efficiency, and longevity.
Step 1: Diagnosis
A thorough diagnosis is the first step to a successful implant treatment. A CBCT scan is taken of the desired area with Axeos® 3D imaging. Its Intelligent Low Dose mode and large field of view make sure acquisition of images are safe and very efficient. This is followed up with an intra-oral scan with Primescan®, which is the starting point of every clinician’s digital journey. Based on these steps, you will be able to determine:
- What type of prosthesis (fixed/removable) is required?
- Are there any hard or soft tissue augmentation procedures required? Any extractions required?
- What are the aesthetic expectations of the patient? Is an interim restoration required?
DS Signature™ Workflows are designed by industry experts in collaboration with clinicians and laboratory technicians for individualised treatment for single tooth, partial and full-arch replacements. Adapting these set workflows helps you to avoid common challenges related to impression inaccuracies, hard and soft augmentations, and surprises during treatment, thus leading to increased patient comfort and satisfaction. From scanning to the final prosthesis delivery and maintenance, each step is custom built for you and your patient.
Step 2: Plan & Communicate
The data acquired from the CBCT scan and intraoral scanner, is merged using Simplant® Pro software which enables you to plan your implant surgeries and design surgical guides (Simplant® Guide) from a prosthetically driven point of view for stress-free and predictable implant placements. This software is also compatible with your preferred implant brand, CBCT and intraoral scanners. All this data can be stored in DS Core®, a new cloud-based service to foster faster collaborations between dentists, laboratory technicians and partners. Treatment plans can be presented to your patients for easy visualisation helping them make an informed decision. This also creates a sense of comfort and confidence among the patients regarding the treatment process, increasing case acceptance.
Step 3: Treat
For single tooth replacements, dental implants are a predictable and straight-forward treatment modality. With the DS Signature™ Workflows, you can now lead your patients from augmentation (if required) to surgical placement to temporisation in the same appointment. Augmentation can predictably be performed using OSSIX® Bone grafts which is a sponge like ossifying block with hydroxyapatite and sugar cross-linked collagen matrix. It is available in 3 dimensions depending on the clinical situation to be used. It can also be used in conjunction with OSSIX® Plus, a porcine-derived, resilient resorbable collagen membrane. This membrane, also available in 3 sizes, has excellent handling properties, adapts easily to defect sites and is resistant to degradation when exposed to the oral environment for 3-5 weeks. In cases where volume augmentation or soft tissue augmentation is required, e.g. in complex anterior aesthetic cases, OSSIX® Volumax (a multi-layer collagen scaffold) is indicated.
Implant placement is done using the Simplant® Guide as determined by the planning software. The guide has a very fast turnaround time of 48 hours from the time of order placement and is compatible with about 100 implant systems. An Atlantis® CustomBase abutment can be ordered together with the guide. The quick delivery of an Atlantis® Core File enables labs or clinicians to manufacture a provisional crown on beforehand to be placed directly after surgery on the Atlantis® CustomBase abutment, when sufficient primary stability is achieved. Alternatively, an Atlantis® Custom Healing Abutment can be ordered pre-operatively and placed after implantation to start forming an adequate emergence profile also avoiding a second surgery for re-opening the implant site.
For multiple implants or in cases of full arch rehabilitations, the diagnosis and planning procedures are similar to the single tooth cases. The Smartfix® concept enables clinicians to offer most edentulous patients fixed teeth on the day of the implant surgery. It is economical for both the patient and the clinician as it avoids complex bone grafting and advanced procedures and involves minimal chair side time for the dentist. Powered by the DS Signature™ Workflows in support with DS Core®, the laboratory technician can order a Simplant® Guide and a Simplant® Core File, which is exclusively available for Dentsply Sirona implant brands. This file can be used to design and fabricate a precise full mouth temporary bridge, which is functional and aesthetic at the same time. This Smartfix concept can be used with Dentsply Sirona implant brands such as PrimeTaper™ EV, Astra Tech™ implant system EV and the new OmniTaper® EV.
For the final restorations, Primescan® is used for digital implant impressions. Atlantis® CustomBase abutments offer screw retained single tooth restorations, which are compatible with the implant system of your choice. Ordering this abutment with the Atlantis® Crown in Cercon xt ML multilayered zirconia allows enhanced aesthetics, especially in the critical anterior aesthetic zone. These crowns are available in 4 cut-back options to allow the laboratory technician for individual characterisation. For cemented restorations, the Atlantis® abutment is available in titanium, gold-shaded titanium and zirconia, on which an Atlantis® Crown in Cercon® xt ML can be cemented. Alternatively, an Atlantis® Core File can be ordered and the crown milled with Primemill™, empowering the clinician with superior chairside capabilities. Final characterisation can be done by the Celtra® Ceram DS Universal Stains to get a natural life-like restoration.
For restoration of multiple teeth, Atlantis® BridgeBase provides a suprastructure for digital restorations. These superstructures are 3D printed in titanium, making them lightweight with a more detailed design and finish. An Atlantis® Core File, which is the digital representation of the total case, including the outer surface of an Atlantis BridgeBase, can be ordered to mill the aesthetic secondary structure out of PMMA or Zirconia. It eliminates the need for a model and enables the reduction of patient visits for jigs and fit-ins. In the post-op phase, Primescan® can be used for recording the gingival heights, which can be used as comparison with the pre-op digital scans. Xios® intraoral imaging can record digital radiographs of the implants, which help to assess the bone levels around the implants and rule out any peri-implant infections.
Step 4: Monitor and Support
Successful treatment of a patient with dental implants involves co-ordination and communication between various agencies such as the patient, implant surgeon, prosthodontist, dental laboratory and the implant company. While running a successful practice, this daily co-ordination becomes a hassle. This is where the cloud-based DS Core® software comes into play. This platform combines products, services, and technologies to help shape the future of your dental practice leaving adequate time to focus on patient treatments. Its interconnected, digitally advanced platform is designed to help you through the entire patient journey, right from diagnosis to the maintenance phase. Additionally, this platform allows you to access your patient files, x-rays, intra-oral scans and other related documents from the dental practice or even remotely. The Create feature of the software allows you to delegate the CAD workflow to a DS Core® Create lab for designing your desired product. Within 6 business hours, you receive a design proposal to review, which can be easily printed with Primeprint®. The Care feature of the software provides technical support and online product and workflow knowledge to address any questions regarding any product or service that may arise during the treatment procedures. This unparalleled support with efficient service and customer support allows practitioners to focus on the dental well-being of their patients.
Digital technologies are replacing the conventional workflows and soon becoming the standard of dental care. Embark on this journey with Dentsply Sirona, the world leader in digital dentistry, and witness a revolutionary change in seamless integration, equipment, and software in your dental offices.
