hello and welcome to your side live I'm Megan strong and I'm will Schmitt registered dental
assistant here at gladwell dental welcome in to class today he's taking us back to school one
more time yeah it's scan school in this episode he's gonna show us his scanning procedures for
scanning a posterior combination case we've got a three unit bridge adjacent to a single crown
well you set it all Megan and once again I'm gonna teach you how to chart this how to link
the bridge together how to set it all up scan it and set it on to the lab for fabrication
well ding ding ding ding ding the bell has rung time for school scan school is back in session
you didn't take the summer off so neither will we'd this episode is going to take you another
step further into rounding out your scanning skill set as always if you're just tuning in
for the first time take a moment to glance at some of my previous episodes especially if you
are a beginner with the I Tarot element scanner let's look at a combination case a posterior
crown for tooth number 28 and a three-unit bridge span from 29 to 31 time to get started I'm going
to start by entering these specific information for each tooth we're scanning the missing tooth
of the bridge span in this case number 30 should be selected first and then marked as missing with
an a' dental i'll move on to the adjacent single unit number 28 next this gets marks as a crown and
I'll start to enter all the specific information in the drop down menu I always wait to enter this
until after the preparations are finished so that I'll have the best opportunity to take a
stump shade and to record margin design now I'll go back and start the data entry for the bridge
I can select either of the bridge abutments here I've chosen number 31 and then mark it as a bridge
don't worry about selecting the additional bridge retainers yet instead a drop down menu is going to
automatically open and provide you the opportunity to select the remaining retainer I'll select tooth
number 29 in this case and my bridge is shown in the view box I can now choose each individual unit
in the bridge and mark them as abutments or as pond ticks to make things easier on myself while
entering specific design features I'll first enter all of tooth number 31 s information manually
I include the required information such as prep design and shade but also details such as the
sump shade now I can select tooth 29 mark it as an abutment and then select the copy from tooth
option at the bottom of the screen as long as the detailed information for this tooth
matches that of a previously entered tooth I can select the matching unit and the information will
automatically be filled in now that all specifics are entered for the bridge I can go back a menu
to the main prescription screen the bridge is clearly charted now with a red bracket line under
the units I'll scroll to the notes section and enter more details about my doctor's treatment
requirements since I previously selected full contours or Konya as the generic material for
fabrication I can use the notes section to clearly state that the prescribing dentist would like the
crown and bridge to both be comprised of Brooke sir solid zirconia this is also the
best opportunity to enter Pontic design features keep in mind that gladwell dental will design a
modified Ridge lap Pontic as the standard unless specified otherwise in the meantime while I've
been entering all the prescription information our doctor has been placing the retraction cords and
preparing for the scan process the double cord technique is being used for these units today
proper retraction is so crucial because we really need to capture all details of these margins and
we don't have the luxury of injecting impression material into the sulcus to make up for any
overhang of tissue anatomical copper caps are also placed after the cords are packed the patient is
asked to bike together and the caps are left for a period of about five minutes I can now move on to
the scanning phase of this appointment I'm going to go ahead and remove these copper caps this
leaves me still with two cords packed into each sulcus just like my previous multi-unit scanning
episode each unit must be scanned individually so I have to be very detail-oriented with these next
steps at this moment the maintenance of tissue retraction is the highest priority I am going
to remove the top cord from number 31 only I'll also keep the tongue retracted and the tooth free
of contaminants I've selected tooth number 31 on the chart the first scan is meant to acquire all
the details of the preparation of tooth number 31 only this scan should be completed in roughly five
to ten seconds if possible I'm not worried about capturing any other details except for number 31
exclusively at this point once I've set aside that I've acquired the proper data I'll give it a quick
look to confirm and then press and hold on the green occlusal marker to move it to the center
of the occlusal position on the preparation moving on I'm going to perform these same steps for the
next tooth number 29 Oh once again removed the top cord only I took a second look and I'm glad
I did because I noticed that the top quarter of 28 was most likely going to interfere with the
scan of 29 so I removed that as well I try to leave all cords in place until the preparation
scan starts unless a situation like this happens now that I'm ready I'll select number 29 on the
chart and once again perform a five-second scan of this preparations details only review it once
completed and move the incisal locator dot as a final step I move right into the prep skin of 28
since the top cord had to be removed once again make sure to move the incisal locator dot to its
best position before continuing at this point I'll go ahead and remove the remaining retraction cords
I do want to mention that the removal of only the top cord during the scan process is just
a guideline if sulky ler bleeding is negligible or you are able to acquire a better scan with no
cords left in place then definitely take both out I do however want to stress that it is important
to perform cord removal on a tooth by tooth basis well have taken Lippert wrecker out of the mouth
at this point I mentioned in a past tutorial that I prefer to perform the full arch scan portion
with no distractions such as retractors or mouth mirrors if I can help it and this situation isn't
any different I've already selected the lower arch on the chart and I'll begin with the contralateral
side if you're a veteran of these scan school videos then the pathway of the wand should already
be second nature to you more importantly during this scan I want to point out a technique to
consider the chart to the left uses white coloring for the teeth that the eye taro suggests to be
scanned and shows the teeth that aren't required in gray as you can see the eye tarot is suggesting
a quadrant scan only for this treatment however similar to full arts physical impressions that
have prepared teeth with no posterior stop this scan should be acquired as a full arch rather than
a suggested quadrant in order to prevent any bite collapse misinformation especially if a model is
requested to be printed and articulated this is the sole reason why I started on the unprepared
side and moved on to the working quadrant scanning a full arch when only a quadrant is indicated will
not adversely affect the eye teros ability to process this model remember the unit will only
suggest best practices it is up to your dentist to determine how complete the scan should be
recorded and then passed that instruction to you before proceeding if the instruction is vague it
never hurts to ask switching to the opposite arch now and as a refresher of the wand pathways I'll
go into just a little more detail here always starting distal to the most posterior tooth in
the arch and on either side that you feel most comfortable scan the occlusal surfaces angle
slightly lingual on the anterior and then reach the same distal destination on the contralateral
side of the arch if you are proficient enough to continue the scan by rotating to the lingual then
that's perfectly acceptable to continue without stopping the interproximal data can be reached
by tilting the wand upwards towards the ceiling on the maxillary arch or downwards towards the
patient's chest for the mandibular arch and then rocking laterally from side to side once the
full arch lingual data has been acquired you can either stop the scan and review or as I'm doing
here continue to the buccal surface if you feel comfortable grab the interproximal buccal data
by rocking the tail of the wand up and down as it travels to the midline where the scan can be
stopped perform the same process from the distal occlusal of the contralateral side move towards
the buccal surface travel to the midline and then stop when the buccal scan meets the previously
acquired data finally I've selected the bite registration option on the chart I'll place the
wand in the opposite vestibule from the prepared side and ask the patient to bite in centric
occlusion start posterior and move the wand in an S or a zigzag motion towards the anterior
and to the arches meshed together the scan can be stopped after the mesh and in the process is
repeated on the contralateral side it is important especially in this situation to capture the bite
registration bilaterally on every full arch scan after ensuring that all scans have been completed
and meshed properly select the view icon to allow the unit to clean up the scans and present them
in a high-definition format from here you can view the occlusal surfaces on a color graded map
these clearances are set to the final restoration material that's been chosen for this particular
case as always the occlusal color map can also be turned off and the scan can be viewed in its post
processed high-definition State exclusively when you are finished give the model one last review
and then press the envelope icon to send this case to the lab for final fabrication thank you so much
well professor we'll always at your service it's so painful so on behalf of everyone here
at Bible dental thank you so much for watching and we'll meet you right back here next time