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logo 16 • the CAMLOG Partner Magazine • June 2017 logo 16 • the CAMLOG Partner Magazine • June 2017 14 15 CASE STUDY Jan Kielhorn, Öhringen ONE CLICK, ONE SCAN, ONE SHIFT – iSy MEETS CEREC: THE DIGITAL WORKFLOW The introduction of new digital technologies, coupled with the possible applications for new materials, has changed the treatment procedures considerably in everyday practice. The present workflows need to be examined continuously with regard to patient demands, costs and profitability. iSy – the intelligent implant system stands for simplicity, modern protocols and an optimized workflow. With its innovative additional components it offers considerable added value and increases efficiency in implant therapy. For CEREC ® users and their patients, the “one click, one scan, one shift concept” offers a new option that saves incredible amounts of time and increasingly places the focus on a fully digital workflow. This workflow is illustrated in the following patient case from planning, via digital impression taking to chairside fabrication of a hybrid crown. The potential of digitization in dental practice is progressing rapidly. The dig- itization of dental radiology has proven to be a useful tool in the area of diag- nostics and planning [1 – 3] . This allows an exact analysis of the patient’s situation and enables determination of the implant positions, lengths, and diameters by over- laying data from a set-up in the sense of backward planning [4 – 5] . The processes of digitization are developing in stages [6] . Individual components are assembled and the digital process chain is extended successively. With the new scan adapters and scanbodies, the iSy Implant System enables CEREC users to fabricate a crown restoration in a single day with a fully digital workflow (Fig. 1) . The patient case The 45-year-old patient presented in our practice in December 2016 requesting to have a gap in the premolar region of the left maxilla filled (Figs. 2 and 3) . The exposure of the tooth gap strongly affected his esthetic perception. This inhibited his carefree approach to talking and laughing. He was therefore looking for a CASE STUDY treatment team which could offer him an inexpensive and time-efficient option for replacing tooth 24. A DVT (Fig. 4) and a comprehensive diagnostic examination showed age-appropriate dentition with a confirmed occlusion with slight bruxism. The determined periodontal screening index was 0-1. Both the wisdom teeth as well as tooth 14 were missing. An impression taken of the situation was followed by treatment planning and an extensive consultation with the patient. As an alternative to reconstruction via implants, we presented the patient with a restoration via adhesive bridge with minimum preparation of the supporting teeth. The patient decided in favor of an implant as he preferred a single tooth restoration to a bridge construction and he did not want to have any filing performed on his canine. However, the precondition for the reconstruction was a restoration that did not exceed his rather limited budget and could be completed in just a few appointments. We offered him immediate restoration on the same day as implant surgery with the iSy System. Using the new iSy scan adapter which is attached to the pre-mounted iSy implant base, and the Sirona scanbody, which is clicked onto the scan adapter, digital impression taking is performed immediately after insertion – without any further intermediate steps or screwing or unscrewing components (Fig. 5) . Fig. 4: The length and position of the implant was determined using volume tomography. Fig. 5: One click, one scan, one shift: the new scan adapters, onto which the CEREC scanbodies are snapped for the intraoral scan, allow fabrication of a restoration with just a single change of abutment. Fig. 2: The clinical situation shows healthy soft tissue with a vestibular bone deficit. Fig. 1: The CEREC ® workflow follows the principle – “one click, one scan, one shift”. Fig. 3: X-ray of the initial situation. Placing the iSy implant Snap on Sirona scan adapter Attach Sirona scanbody Select titanium base CAD/CAM and “ScanPost” as scanbody type For example, scan with CEREC ® Omnicam Remove scan components Snap on gingiva former Design crown Mill crown Finish crown Remove implant base Insert crown SCAN SELECTION