Presentations

Digital Implant Planning

Presented by TrueDefDoctors Faculty member, Dr. Effie Habsha. This clinical case presentation outlines various digital technologies that can be used in diagnosis and treatment planning, implant placement and restoration. The replacement of the lower right first molar was planned on a computer software program (Simplant). A surgical guide was fabricated and utilized for placement of a Zimmer Biomet implant in the 46 site. Adequate primary stability was achieved and a coded healing abutment (Encode) was placed on the implant. The final digital impression of the Encode abutment was made at the time of implant placement using the 3M TrueDefinition scanner. The trusted connection between 3M and Zimmer Biomet allowed for seamless fabrication of a screw retained implant crown and printed models.

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Full Mouth Reconstruction

Presented by TrueDefDoctors Faculty member, Dr. Effie Habsha. This clinical case presentation demonstrates a full mouth rehabilitation with a recovery of occlusal vertical dimension. The 3M TrueDefinition scanner was used for the digital impressions. Both maxillary and mandibular arches were impressed using the scanner and the interocclusal record was recorded in a digital fashion as well. Some challenges were encountered with the digital articulation of the casts, and the solution to the challenge are demonstrated. This case demonstrates that digital impressions can be made for comprehensive, full arch restorations and are not limited to simple single unit cases.

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2016 Digital Exchange

Presented by Faculty member and founder of Truedefdcotors.com, Dr John F Weston DDS FAACD. This lecture is part of the live patient demonstration that Dr Weston completed at the meeting. It covers information about Zirconia and the rise of monolithic systems. It’s basically the set up for the case that was scanned and finished on stage. Lava Esthetic, 3M’s new translucent material is discussed and a case is presented that shows the pre-op, prep and final views of #18 and #19 that were treated using Lava Esthetic.

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10 Veneers – “Michelle’s Canted Smile”

Presented by Faculty member and founder of Truedefdcotors.com, Dr John F Weston DDS FAACD. This 43 year Old Female presented with complaint of not liking her smile. Exam revealed asymmetric attrition and canted maxillary smile line with discolored and disproportionate anterior teeth. She proceeded with orthodontic consult but chose not follow the recommended orthodontic treatment plan due to her job and travel schedule. DSD was completed and trial smile tested chair-side prior to prep appointment. The results of the trial smile satisfied our treatment goals so the patient elected to proceed with a restorative correction of her smile. She understands the importance of bite protection and the effects on her teeth if she is not compliant. The case was completed with e.max porcelain and delivered using a total etch technique and 4th generation bonding. A quicksplint deprogrammer was fabricated for night time use.

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Digital Ceramic Bridge

Presented by Faculty member Dr. Chad C. Duplantis. This case was planned with coDiagnostiXTM, a guide was printed, then we scanned with mono scan bodies with a 3M Truedefinition scanner, imported into Straumann Dental Wings 7Series, had a Dreve model made and utilized Straumann’s repositionable analogs, designed as a VarioBase Bridge utilizing Straumann Lava Plus, Variobase Bridge abutments were cemented into place with Panavia SA Cement, Vita VM9 ceramics were used. The final case was then delivered, torqued to 35 Ncm, and Teflon tape, opaque composite and filtek supreme (3M) was used to fill the access.

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Straumann Workflow #3 Bone Level with Video Demonstration

Presented by Faculty member and founder of Truedefdcotors.com, Dr. John F Weston DDS FAACD. This 40 year old female patient presented with a failing upper right tooth #3. The tooth was removed and immediate site preservation completed via bovine bone graft. After 5 months a Straumann Bone Level RC implant fixture was placed. After 2 months healing, the True Definition Straumann Trusted digital workflow was utilized to fabricate the custom Titanium abutment and e.max crown in one step. A custom abutment allows for ideal margin placement and reduces the chance of peri-implantitis secondary to sub-gingival cement around the implant. The crown was adjusted so it just clears shim-stock to reduce the chance of porcelain fracture in heavy occlusion.

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Sub-gingival Scanning

Presented by Faculty member and founder of Truedefdoctors.com, Dr. John F Weston DDS FAACD. This patient presented with a failing porcelain fused to metal crown on the lower left. Deep decay was present on the distal buccal. After root canal therapy, a build up and prep was completed resulting in a deep margin extended well below normal tissue sulcus levels. Paste retraction by Kerr was used along with Viscostat hemostatic agent. Once the area was totally dry and the margin could be visualized, contrast spray was applied and sulcus air dried aggressively to clear extra powder. The scan was easily completed and sent to the lab for margin marking and fabrication of a Zirconia based ceramic layered crown. The fit was excellent with no adjustment needed on delivery with Unicem 2 resin cement.

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Zirconia Substrate Layered Crowns #7-#10

Presented by Faculty member Dr. Chad C. Duplantis. This patient presented with failing anterior porcelain crowns and recurrent decay. Preps were completed and teeth isolated, scanned and sent to the lab for fabrication of zirconia framework based micro layered crowns. One reason this is a nice choice is these types of crowns can be conventionally cemented similar to PFM crowns. Placement was completed using a resin based cement.

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Custom Implant Abutment and Crown #13

Presented by Faculty member Dr. Chad C. Duplantis. This patient presented with a Straumann 3.3 Roxolid Implant that was integrated and ready for restoring. The proper scan body was placed and both arches scanned. The scan body is removed for the bite registration. On delivery day, the custom abutment is tried in finger tight, and crown tried on. Once everything is checked for fit, the abutment is torqued to 35nc and crown cemented with a resin based cement.

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Ceramic Veneer #7

Presented by Faculty member Dr. Chad C. Duplantis. This patient presented with a missing porcelain veneer. The prep was refined and scan sent to the lab. The nice part about using the True Definition scanner is that a model can be fabricated and a custom layered veneer can be fabricated in traditional fashion. Delivery was completed using a light cure resin cement and total etch bonding system.

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Zirconia Substrate Layered Crown #20

Presented by Faculty member Dr. Chad C. Duplantis. This patient presented with a failing porcelain fused to metal crown and recent root canal therapy. Using a zirconia framework with ceramic micro layering is an excellent choice for this area and can be conventionally cemented similar to PFM crowns. When prescribing this type of crown it’s important your lab knows how to properly fire these restorations. The heating and cooling cycles are critical for long-term success. The digital file was sent to the lab who marks the margin and fabricates in a traditional manner using a model. Placement was completed using a resin based cement.

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IOS TS 150 Chair-side Mill

Presented by Faculty member Dr. Nicholas Marongiu, DDS. This 55 year old female presented with a failing composite restoration and recurrent decay. It was determined that an indirect restoration would be an excellent choice for treatment of this medium to large failing composite. The material of choice was Lava Ultimate, chosen for it’s ease of handling and finishing after the milling process. The digital scanned file was sent to the design station and mill via wireless network, which frees up the scanner for immediate use. Placement was completed using a selective etch technique, Universal Composite and RelyX Ultimate resin cement.

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20 Unit Case

Presented by Faculty member and founder of Truedefdoctors.com, Dr John F Weston DDS FAACD. This 51 year old male presented with a worn dentition, rotated teeth and spacing. His teeth appeared short and had limited display with lips at rest. The patient denied orthodontic treatment opting for an immediate solution via indirect porcelain. The case was completed with guidance from the digital smile design. The trial smile, reduction guides and provisonals were all fabricated based on the digital design parameters and helped guide the case to completion.

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Acid Etch Resin Bonded Bridges

Presented by Faculty member and founder of Truedefdoctors.com, Dr John F Weston DDS FAACD. This 25 year old female presented status post orthodontic treatment for space management and erwuested replacement of missing lateral incisors. After 3D imaging, it was decided she was not a good implant candidate due the limited bone width and space between the teeth. Double winged Lava Zirconia Plus frames were used and bonding enhanced by pressing porcelain on the intaglio surfaces.

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4 Unit Posterior Bridge

Presented by Faculty member and founder of Truedefdoctors.com, Dr John F Weston DDS FAACD. This 71 year old male presented with chipping porcelain on the upper left FPD. After removal of the existing 30 year old bridge and recurrent decay, a lava plus zirconia frame with micro-layered ceramic was placed. The fit was excellent with no adjustment needed on delivery. The patient was placed in a night guard for protection. Future treatment is indicated on remaining teeth.

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Prepless Veneers

Presented by Faculty member and founder of Truedefdoctors.com, Dr John F Weston DDS FAACD. This 43 year old male presented with complaint of spacing and what he called “Small Teeth”. It was determined there was a tooth size arch discrepancy situation and “additive” indirect veneers would be the best choice of treatment. The feldspathic veneers were fabricated based on a digital smile design parameters. The digital scanned model was used to fabricate the veneers via foil lift off technique. After deliver a night guard was placed.

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16 Veneers

Presented by Faculty member and founder of Truedefdoctors.com, Dr John F Weston DDS FAACD. This 43 year old male presented with complaint of spacing and what he called “Small Teeth”. It was determined there was a tooth size arch discrepancy situation and “additive” indirect veneers would be the best choice of treatment. The feldspathic veneers were fabricated based on a digital smile design parameters. The digital scanned model was used to fabricate the veneers via foil lift off technique. After deliver a night guard was placed

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Straumann Implant Bone Level NC

Presented by Faculty member and founder of Truedefdoctors.com, Dr John F Weston DDS FAACD. This 59 year old male patient presented with a fractured lower left premolar. The tooth was removed and site preservation completed via bovine bone graft. After 5 months a Straumann Bone Level NC implant was placed. After 2 months healing, the True Definition Straumann Trusted digital workflow was utilized to fabricate the custom Zirconia abutment and e.max crown in one step. A custom abutment allows for ideal margin placement and reduces the chance of peri-implantitis secondary to sub-gingival cement around the implant.

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Straumann Implant Bone Level RC

Presented by Faculty member and founder of Truedefdoctors.com, Dr John F Weston DDS FAACD. This 51 year old male patient presented with a fractured lower left second molar. The tooth was removed and immediate site preservation completed via bovine bone graft. After 5 months a Straumann Bone Level RC implant was placed. After 2 months healing, the True Definition Straumann Trusted digital workflow was utilized to fabricate the custom Zirconia abutment and e.max crown in one step. A custom abutment allows for ideal margin placement and reduces the chance of peri-implantitis secondary to sub-gingival cement around the implant. The crown was adjusted so it just clears shim-stock to reduce the chance of porcelain fracture in heavy occlusion.

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Straumann Implant Tissue Level WN

Presented by Faculty member and founder of Truedefdoctors.com, Dr John F Weston DDS FAACD. This 37 year old male patient presented with a non restorable upper left 1st molar. The tooth was removed and immediate site preservation completed via bovine bone graft. After 6 months a Straumann tissue Level WN implant was placed. After 3 months healing, the True Definition Straumann Trusted digital workflow was utilized to fabricate the custom high noble metal abutment and e.max crown in one step. A custom abutment allows for ideal margin placement and reduces the chance of peri-implantitis secondary to sub-gingival cement around the implant. The crown was adjusted so it just clears shim-stock to reduce the chance of porcelain fracture in heavy occlusion.

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