Dr. Eitan Mijiritsky
DMD, PhD
• PhD Summa Cum Laude, on the topic of Immediate Loading in Oral Implantology
• Associate Professor in Prosthodontics and Coordinator of International Academic Affairs of the School of Dental Medicine at the Tel-aviv University School of Dental Medicine
• Prosthodontic Consultor and Research Coordinator – Dep. of Oral and Maxillofacial Surgery, Sourasky Tel-Aviv Medical Center
• Past President of the Israel Society of Prosthodontics
• President Elect and Council Member of the European Prosthodontic Association – EPA
• Former Board of Directors of the DDS
• Scientific Committee of the DDS and DDS Ambassador for Israel
• Member of the Editorial Boards of: Journal of Dentistry JD, International Journal of Prosthodontics IJP, Journal of Esthetics and Restorative Dentistry JERD, • Journal of Clinical Medicine JCM
• 130+ scientific publications in peer reviewed international journals
• Heading the “Mijiritsky Dental Experts Center” in Tel-Aviv.
case description
case description
A 49-year-old patient, wearing a complete upper removable denture and an ill-fitting lower removable partial denture (RPD), came to our dental office with a specific request: “I want to replace my lower RPD with a fixed restoration.”
The patient had only four mandibular incisors left (42–32; Fig. 1, 2) and needed six implants for an implant-supported full-arch restoration.
To adjust the occlusal plane, the patient needed a bone reduction procedure in the mandibular anterior zone.
A bone reduction surgical guide and an implant placement surgical guide were planned according to a virtual tooth setup and the implant position (Fig. 3–8).
After the surgical session and the immediate loading of a provisional restoration (Fig. 9–16), and a period of temporisation, a full-arch implant scan was captured with an intraoral scanner (IS 3800W®, DEXIS; Fig. 17).
“A full-arch implant scan was captured with an intraoral scanner.”
The scan was used for designing a full-arch monolithic zirconia tubelock split-framework design with Exocad software (Fig. 18–23).
By splitting the restoration into two parts, the potential detrimental effects of the mandibular flexure phenomena in the mandible on splinted full-arch restorations can be overcome (Figs 24–27).
In addition, a split-framework design can help achieve better accuracy when working with full-arch intraoral scanning.
NOTES
*Accuracy Test Methods
For evaluation of the accuracy, two aspects (trueness and precision) were tested respectively employing methods commonly adopted by the industry.
A gypsum dental model was scanned beforehand by an industrial grade scanner to generate a dataset as reference for trueness testing where a single, trained operator used AS 260 to scan the same model for 10 separate times to obtain datasets (all STL formatted).
The datasets were then superimposed to the reference dataset for 3D comparisons to acquire 10 average error values, the mean of which was calculated to describe the trueness.
In terms of precision measurement, pairwise comparisons between the 10 datasets were operated and the average error of each comparison was calculated to generate 45 different values, the mean of which was then used to represent precision.