Creating Verified Models for All-on-Four Cases with Intra Oral Scanner
This guide will provide an overview of a method that allows a clinician with an intra oral scanner, such as the Medit i500, an easy and streamlined method of creating a verified, final model and deliver a temporary all-on-four restoration.
The clinician must provide the following to the laboratory:
Wax Rim: For checking Vertical Dimension (VD). Clinician can send physical copy to laboratory, or scan the wax rim (in its entirety) with the IOS and send the digital file.
IOS Scan of the arch + scan w/ Scan Bodies
The laboratory can use the above information and fabricate the PMMA temporary restoration.
TWO temporary restoration (both exactly the same) will be delivered from the lab.
One will be used as a verification jig and the other as temporary restoration.
Both will have large holes where the abutments will fit into. With the first one, do the following:
You can either use temporary cylinders or titanium bases. Screw either into the implants, seat the temporary restoration, then fill the implant holes with cold resin.
Check the bite; if the posteriors are too high, feel free to remove large portions of the PMMA. Once the bite looks good, take a bite registration.
Check the teeth position & shapes: mark your changes, as you would on a full arch denture case. If you have smile design software such as Rejuveneer (https://rejuveneer.com/), this process can be done without leaving marks on the PMMA arch.
This first PMMA restoration is the verified model, bite check, and teeth setup. Return this to the laboratory with the new bite registration and they can make the final restoration with it.
The above steps can be repeated on the second PMMA restoration and provided to the patient as the temporary restoration, while the final is produced.