70
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CERECDOCTORS.COM
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QUARTER 1
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2016
in this recurring section of the magazine
, we share a sample of conversations occurring online:
With more and more options with placing implants predictably, a doctor asks for help in designing a guide.
D I S C U S S I O N F O R U M
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JEREMY HELDT
Not sure if this is the correct way to do an extract
and immediate case using CEREC Guide 2 on
Galaxis. The videos I’ve seen so far
have been planning with an eden-
tulous space; so just decided to try
planning the case anyway with the
tooth still there. After scanning the
full arch, I proposed and designed the
implant crown (filling in the lingual
cusp that broke off ), exported the
.ssi file into Galaxis, correlated the
optical impression with the CBCT
and planned the implant. With the
tooth still being there, wasn’t sure if
there was a better way to design the
CEREC Guide 2, but it seems like
it came out OK here. Should I have cut out the existing tooth
during the design phase? Any suggestions appreciated. Thanks.
JIM YANKOWSKAS
Jeremy, from what I can see, it seems OK. I will
actually design in both ways depending on the
patient’s occlusion. We will sometimes cut or replace the
tooth to be extracted to allow the best possible CEREC
design, but if the tooth appears to be in a correct relationship
do exactly what I believe you are showing here.
FARHAD BOLTCHI (FACULTY)
You will not be able to mill a CG 2 with the tooth
still in place, i.e. immediate implant placement.
You will either need to cut the tooth out on a model or digi-
tally before designing the CG2.
Compiled from
CEREC Guide 2:
Extract and Immediate Planning
Is This a Viable Option?
MARK STOCKWELL
I do remember Farhad speaking about this in
regards to milling errors: where the software was
being asked to disregard the interference, and not being able
to mill the guide. Solution was either to do model-based and
adjust the model, or digitally with form tool in model edit
prior to exporting. Just what I remember. If it milled, and you
verify seating, maybe you are good to go.
MARK STOCKWELL
One minute late ... but glad for confirmation.
MIKE SKRAMSTAD (FACULTY)
I have done it, but it’s extremely difficult, as
Farhad can attest to. You have to virtually cut the
tooth out to have no interferences with the CG2 hole and not
distort the tooth as to affect fit. Very advanced technique and
not really recommended.
JEREMY HELDT
Would a supra-occlusal sleeve work?
